Objective To study whether preoperative serum thyrotropin ( TSH) concentration can be used for risk prediction of papillary thyroid microcarcinoma ( PTMC ) . Methods The cohort of this retrospective study consisted of 1 707 patients who underwent surgery on thyroid nodules at Chinese PLA General Hospital from October 1999toFebruary2011. 37.32%(n=637)ofthesepatientssufferedfromdifferentiatedthyroidcancer(DTC),and 14. 18%(n=242) of patients with DTC suffered from PTMC. Results (1) The mean TSH level in patients with DTC was significantly higher than that in patients with benign thyroid nodules [(1. 99(1. 25-3. 19) vs 1. 48 (0. 85-2. 32) mU/L, P<0. 01]. DTC with diameter greater than 10 mm had higher serum TSH level compared with that in benign thyroid nodules[2. 04(1. 26-3. 36) vs 1. 45(0. 83-2. 30), P<0. 01]. Serum TSH level was not significantly raised in cases where-as the diameter of tumor was 10 mm or less. (2) With the increasing level of TSH, the prevalence of DTC and tumours with diameter greater than 10 mm rose significantly, but the increasing trend was not significant in PTMC. (3) Raised TSH level was an independent risk factor of DTC based on Binary logistic regression. Conclusions Serum TSH is an independent risk predictor of DTC, it is an independent risk predictor of the diameter of DTC greater than 10 mm, but it is not a good risk predictor in PTMC.

Objective? To explore the effects of WeChat combined with module teaching in minimally invasive surgery nursing training. Methods? From July 2016 to June 2018, 56 junior nurses in operating room were randomly divided into control group and experimental group, 28 nurses in each group by random table. Control group carried out routine teaching combined with module teaching, while experimental group adopted WeChat combined with module teaching. We compared the theoretical achievements, skills performance and satisfaction of surgeons with nursing. Results? Twelve months after training, the theoretical achievements and skills performance of experimental group were (76.93±5.31) and (78.79±4.86) respectively, higher than those of control group with statistical differences (t=-3.34, -3.13;P＜ 0.05). Satisfaction of surgeons with nursing provided by nurses was (94.68±3.37) in experimental group and (72.26±4.67) in control group with a statistical difference (t=-35.64,P＜ 0.05). Conclusions? The application of WeChat combined with module teaching in minimally invasive surgery nursing training for junior nurses can stimulate the enthusiasm of autonomous learning, raise the theoretical achievements and skills performance and improve satisfaction of surgeons with nursing for surgeries.