Objective To investigate the differential diagnostic signiifcance of different calciifcation types in thyroid benign and malignant nodules with high-frequency ultrasound. Methods Totally 195 patients with thyroid lesions were examined on conventional high-frequency ultrasound pre-operatively. The evaluation was foucsed on the number and echo of thyroid nodules and the size, shape and distribution of calciifcation inside. Different calciifcation patterns were divided into 3 types:type 1 micro-calciifcation, type 2 coarse calciifcation, type 3 peripheral calciifcation. Results The calciifcation rate of thyroid malignant nodules 68.6%(81/118) was signiifcantly higher than that of benign nodules 40.0%(56/140) (χ2=21.096, P<0.01). The ratio of type 1 calciifcation in malignant nodules 72.8%(59/81) was obviously higher than that of benign nodules 41.1%(23/56) (χ2=13.906, P<0.01). There was no signiifcant difference of type 2 calciifcation between malignant and benign nodules (χ2=3.159, P>0.05). The incidence of type 3 calcification in malignant lesions 3.7%(3/81) was lower than that of benign nodules 21.4%(12/56) (χ2=10.669, P<0.05). The malignancy incidence of solitary thyroid nodule 85.3%(58/68) and extremely low echo nodules with calciifcation 76.2%(48/63) was higher than that of multiple thyroid nodules 33.3%(23/69) and other echo nodules 44.6%(33/74) (χ2=38.261, 14.057, both P<0.01). Conclusions There was potential risk of malignancy in each calciifcation of thyroid nodules. Different calciifcation types had important value for differential diagnosis of benign and malignant thyroid nodules.

Objective To discuss the key points of nursing care for patients using ultrasound-guided microwave coagulation therapy with artificial pleural effusion for liver carcinoma in the hepatic dome.Methods The preoperative and postoperative data of 34 patients who were hospitalized in our hospital from June 2004 to February 2009 were reviewed.Results All the patients finished the treatment successfully.Slightly chest distress was the most frequently complication correlated to artificial pleural effusion,mostly disappeared in 3-7 days.Only 3 patients suffered from dyspnea and a decrease of SpO_2 in the second day after the treatment.The symptoms were relieved after a drainage of pleural.The common side effects of microwave coagulation therapy were found as fever,pain during deep respiration and liver dysfunction,which were relieved after symptomatic treatment and nursing care.No severe complication was found.Conclusions Adequate preoperative preparation,proper intraoperative cooperation,close postoperative observation and nursing are the key points to decrease complications.

Objective:To analyze therapeutic effect and safety of triple intensive anti -platelet therapy on patients with acute myocardial infarction (AMI) complicated type 2 diabetes mellitus (T2DM) .Methods:A total of 100 AMI + T2DM patients were enrolled and equally divided into routine treatment group (received aspirin and clopi‐dogrel treatment based on routine treatment ) and tirofiban group (received tirofiban based on routine treatment group) .Platelet count (PLT) ,platelet activating factor (PAF) ,prothrombin time (PT) ,activated partial thrombo‐plastin time (APTT) ,fibrinogen (Fg) ,left ventricular ejection fraction (LVEF) ,left ventricular fractional short‐ening (LVFS) ,stroke volume (SV) and therapeutic effect were measured and compared between two groups .All patients were followed up for six months ,incidence rates of major adverse cardiovascular events (MACE) and vari‐ous hemorrhage events were compared between two groups .Results :Compared with routine treatment group ,there were significant reductions in PLT [(18.2 ± 2.5) 109/L vs .(15.8 ± 1.4) 109/L] and PAF [(138.6 ± 10.2)μg/L vs . (61.5 ± 3.1)μg/L] (P<0.05 ,<0.01);and significant rise in LVEF [ (56.9 ± 5.2)% vs .(64.2 ± 4.6)% ] ,LVFS [ (30.4 ± 3.3)% vs .(39.8 ± 4.5)% ] ,SV [ (43.2 ± 3.4) ml vs .(74.5 ± 4.6) ml] and total effective rate (76.0%vs .96.0% ) in tirofiban group , P<0.05 all .After six-month follow-up ,there were no significant difference in incidence rates of MACE and bleeding between two groups , P>0.05 all .Conclusion:Therapeutic effect of triple in‐tensive anti-platelet therapy is significant in AMI + T2DM patients ,and its adverse reactions and prognosis have no difference with those of dual anti -platelet therapy .

Objective:To analyze the clinical therapeutic effect and safety of bare metal stent (BMS)application in patients with coronary heart disease (CHD)complicated impaired glucose tolerance (IGT).Methods:The data of 68 CHD + IGT patients undergoing stent implantation in our hospital were retrospectively analyzed.According to kind of implanted stents,they were divided into BMS group (n=36)and drug eluting stent (DES)group (n=32). Thrombolysis in myocardial infarction (TIMI)flow grade and Gensini score of coronary lesion were compared be-tween two groups via reviewing coronary angiography six months after operation.Incidence rates of re-stenosis,a-cute thrombosis,sub-acute thrombosis,revascularization and sudden death were compared between two groups after one year follow-up.Results:There were no significant difference in TIMI grade and Gensini score of coronary le-sion between two groups after operation (P>0.05).Compared with DES group after one-year follow-up,there were significant reductions in incidence rates of acute thrombosis (6.25% vs. 2.78%), sub-acute thrombosis (15.63% vs.5.56%)and sudden death (6.25% vs.2.78%)in BMS group (P<0.05 all),but there were no signif-icant difference in incidence rates of re-stenosis and revascularization between two groups (P>0.05).Conclusion:Application of bare metal stent can reduce incidence rate of postoperative complications and possess better therapeu-tic effect in patients with coronary heart disease complicated impaired glucose tolerance.

Objective To investigate the evaluation of virtual touch tissue quantification(VTQ)in differential diagnosis of thyroid benign and malignant nodules and its influence factors.Methods 127 patients with thyroid lesions and its adjacent normal thyroid tissue at the same depth were examined with VTQ.Test results were performed by shear wave velocity value (SWV) on the long axis dimension of the nodules.The maximum(Vmax),minimum(Vmin) value of SWV of thyroid lesions and the SWV(Vn) value of surrounding normal tissue were recorded.The mean value of SWV (Vm) and the ratio of Vm and Vn (Vm/n) were calculated.SWV value of benign and malignant nodules and different pathological types of nodules were analyzed.Receiver-operating characteristic curve(ROC) was drawn to assess the diagnostic efficiency.Results The Vmax,Vmin,Vm,Vm/n of malignant lesions [(4.61 ± 2.65) m/s,(2.74 ± 2.23) m/s,(2.99 ± 0.82)m/s,(1.69 ± 1.07)m/s,respectively] were obviously higher than that of benign nodules [(2.78 ± 0.96)m/s,(1.75 ± 0.60)m/s,(2.31 ± 0.38)m/s,(0.94 ± 0.23)m/s,respectively,P ＜0.01].The SWV value of thyroid papillary carcinoma was higher than that of nodular goiter,thyroid adenoma and Hashimoto's thyroiditis(P ＜0.05).The SWV value of Hashimoto's thyroiditis was higher than that of thyroid adenoma and nodular goiter (P ＜ 0.05).No significant differences of SWV value were found between thyroid adenoma and nodular goiter (P ＞ 0.05).Contrast the area under the receiver-operating curves above four groups of different SWV values,the results showed that Vm had the highest diagnostic value in diagnosis of benign and malignant thyroid nodules.When the best cut-off point of Vm was 2.48 m/s,the diagnostic value was highest and the sensitivity and specificity were 97％ and 81 ％.Conclusions VTQ could be used to quantify and evaluate the hardness of thyroid nodules and provided important value for the differential diagnosis of benign and malignant thyroid nodules.

This paper explores the reasonable construction of disease settlement standard system based on production process and source of costs, charging standards and the quantitative relationship between disease and settlement, putting forward clinical path minimum settlement standard and regulate a major guideline for settlement standard for local diseases by excluding the excessive service from patient's wills, high value consumables and high-priced drugs based on clinical path cost variation coefficient measured by disease typing and actual cost variation coefficient determined by class of hospital.

0.05).Conclusions The expression of galetin-3 was obviously increased in liver metastasis from colon cancer,and MCP can effectively inhibit the development of liver metastasis of colon cancer.

Objective To contrast between the advantage and disadvantage of CR system and screen-film combination in the hypomastia mammography. Methods 233 cases underwent high frequency mammography unit made in Itlian, screen-film combiation and CR system made in Japan, in addition, the imaging quality was analyzed. Results The image quality of CR system was better than screen-film combination. The rate of photographing again outstandingly declined. The radiation to patient decreased evidently. Conclusion CR system is better than traditional screen-film combination in the hypomastia mammography.

Objective To observe the operation of Nav1.6 voltage-gated sodium channels in rats with acute cerebral injury after electroacupuncture therapy and investigate the mechanism.Methods Male Sprague-Dawley rats were randomly divided into an ischemia control group (IC,n =48),an electroacupuncture group (ET,n =48),a nimodipine therapy group (NT,n =48) and a sham operation group (SO,n =24),and were treated accordingly.A model of acute cerebral ischemia was induced by occlusion of the right middle cerebral artery using the suture method.The expression of Nav1.6,the concentration of Ca2+ and infarct volume were observed at 6 h,1 d,2 d and 3 d after ischemia with the real-time quantitative fluorescence PCR,immunofluorescence and 2,3,5-triphenyl tetrazolium chloride methods,respectively.Results The Joshua score for neural function was zero in the sham operation group,and increased gradually in the three other groups 6 h and1 and 2 d after ischemia.The average Joshua score 3 d after ischemia was significantly lower than 1 d earlier in each group.In the ET group the expression of Nav1.6 was significantly upregulated at first,followed by a significant decrease.The concentration of Ca2+ behaved similarly.However,no significant changes were observed in the infarction volume percentage.At 3 d after ischemia the expression of Nav 1.6,the Joshua grades,the Ca2+ concentrations and the infarction volume percentage were all significantly lower in the ET group compared with the IC,NT and SO groups.Conclusion Electroacupuncture therapy after acute cerebral ischemia can inhibit the expression of Navl.6,reduced Na + inflow and calcium overload,and mitigate acute cerebral ischemic injury,at least in rats.The protective effect may be attributed to inhibiting the expression of Nav 1.6.

Objective To explore the relationship of bFGF in the pathogenesis of gastric cancer.Methods The expression of bFGF was determined by immunohistochemical method in 130 gastric specimens including 30 cases of chronic superficial gastritis,30 cases of intestinal metaplasia,30 cases of dysplasia and 40 cases of gastric carcinomas.Results In control group with chronic superficial gastritis,precancerous group,and gastric carcinoma group,the expression level of bFGF had a increasing tendency(P ＜ 0.05).Conclusion The expression of bFGF was up-regulated in the carcinogenesis of gastric carcinoma.