Objective To explore the prevalence and related risk factors of thyroid nodule in elderly patients(age ≥ 60 years old) with type 2 diabetes mellitus(T2DM)) in Xinjiang region.Methods Two hundreds and two elderly patients with T2DM were selected,including 91 cases of thyroid nodule(thyroid nodule group) and111 cases of non-thyroid nodule (control group).The disease history,body mass index(BMI),fasting blood-glucose (FBG),2-h postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c),triglyceride(TG),cholesterol(TC),high-density lipoprotein(HDL-C) and low density lipoprotein(LDL-C) were collected for statistical analysis.Results The age,gender,BMI,TC and HbA1c had statistical difference between the two groups (P<0.05);the disease course,pulse pressure,systolic pressure,abdominal perimeter,smoking history,HDL,TG,FBG and 2 h PBG had no statistical differences netween the thyroid nodule group and non-thyroid nodule group (P>0.05).The multivariable Logistic regression analysis showed that the age,gender,TC,HbA1c and BMI were the risk factors of thyroid nodule occurrence.Conclusion Conducting the thyroid nodule related imaging examination has an important clinical significance for diabetic elderly women patients with obesity and cholesterol increase.

OBJECTIVETo evaluate the predictive accuracy of the SurgiCase CMF software in surgical simulation and prediction for mandibular asymmetry with 3-dimensional simulation and measurement.

METHODSCBCT data of 27 patients with mandibular asymmetry were observed in CMF, and postoperative soft tissue physiognomy were predicted by simulating sagittal ramus osteotomy with or without genioplasty. The measurement parameters representing the symmetry of soft tissue were selected and the horizontal, coronal and sagittal planes were established. The results were analyzed by SPSS 19. 0. The overlap compared color grading charts were observed.

RESULTSAngles between cheilions and the horizonta plane (Ch-Ch-FH) in the simulation and postoperative soft tissues are (2. 35 ± 1. 81)° and (1. 44 ± 1. 13)°. The angles constructed among subnasale, upper lip and lower lip (Sn-UL-LL) are (4. 02 ± 3. 05)° and (2. 59 ± 1. 64)°, showing statistically different (P < 0. 01, P < 0. 05), which means that predictive accuracy of the lip canting and lip vertical deviation is relatively low. Distance between gonioi and sagittal plane (Go'-MS), distance between gonion and pogonion (Go'-Pog') and angle betweer subnasale to menton and the horizontal plane (Sn-Me'-MS) are not statistically different, which mean! high predictive accuracy of mandibular angle and chin. By observing the overlap compared color gradin-) charts, the predictive accuracy is not good in the cheek, especially in the deviate side.

CONCLUSIONSThe predictive accuracy of CMF system for patients with mandibular asymmetry is relatively high, but it is not good in the lip and cheek. The software improvement is still necessary.

Cephalometry ; methods ; Chin ; anatomy & histology ; Cone-Beam Computed Tomography ; methods ; Face ; Humans ; Lip ; anatomy & histology ; Mandible ; abnormalities ; surgery ; Osteotomy ; methods ; Software ; Surgery, Computer-Assisted ; methods

BACKGROUND:Bilateral-sagitta-split-ramus-osteotomy (BSSRO) has become a conventional method to correct facial deformities, and the finite element method is a significant way to study biomechanics of the mandible and temporomandibular joint (TMJ) after BSSRO. OBJECTIVE: To establish a precise and high simulation model of mandible containing TMJ after BSSRO with internal fixation, which is the base to study the biomechanics of the mandible and TMJ after BSSRO. METHODS: Spiral CT scan was used to get the data of DICOM that were input into MIMICS to establish the three-dimensional model of the mandible. The three-dimensional model was wrapped into a single closed shel for mesh generation and conversion in ANSYS. Then, the model was input into the ANSYS software for temporomandibular joint reconstruction and simulation of BSSRO and internal fixation. RESULTS AND CONCLUSION: The three-dimensional finite element model of mandible containing TMJ after BSSRO was established using MIMICS and ANSYS. This model had biological similarity and geometric similarity in comparison with the human tissues. The model could undergo various internal fixations through antedisplacement, retroposition and rotational movement of the distal end. Based on different experimental purposes, the established model can apply a load to al parts to study changes in stress and displacement of different tissues after BSSRO and internal fixation, and it also can be used to study the effect of different fixation materials on the rear stability after internal fixation.

Objective To explore the value of thromboelastography (TEG) in patients with multiple trauma in emergency department. Methods The clinical data of 302 patients with multiple trauma hospitalized in the emergency department of Gansu Provincial People's Hospital from August 2015 to December 2018 were retrospectively analyzed. The general clinical data of the patients were collected. The patients were divided into three groups according to injury severity score (ISS): mild injury group (ISS ≤ 16), serious injury group (ISS 17-25), and severe injury group (ISS > 25). The results of vital signs, routine coagulation test, blood routine, blood biochemistry, and arterial blood gas analysis were recorded, and the National early warning score (NEWS) was calculated. TEG parameters were analyzed. Pearson correlation analysis and linear regression analysis were used to analyze the correlation between TEG indicators and NEWS score. Receiver operator characteristic (ROC) curve was plotted to analyze the diagnostic efficacy of TEG indicators for disseminated intravascular coagulation (DIC) in patients with severe injury. Results 299 patients were enrolled in the final analysis, including 92 patients in the mild injury group, 109 in the serious injury group and 98 in the severe injury group. With the increase in trauma severity, the NEWS score and TEG indicators including coagulation reaction time (R value) and blood clot generation time (K value) were gradually increased [NEWS score in mild, serious, and severe injury group was 3.46±0.89, 5.85±0.62, 9.75±1.76, R value (minutes) was 5.8±2.8, 7.8±2.6, 11.7±3.0, and K value (minutes) was 2.4±1.0, 4.2±1.4, 5.5±2.9, respectively], and blood clot generation rate (α angle), maximum width value (MA value) and coagulation index (CI) were gradually decreased [α angle (°) in mild, serious, and severe injury group was 66.9±13.5, 55.7±22.9, 46.8±26.3, MA value (mm) was 51.8±9.7, 48.1±17.0, 38.5±15.2, and CI was 2.0±3.6, -2.8±3.5, -6.7±2.9, respectively], the differences were statistically significant among the groups (all P < 0.05). Pearson correlation analysis showed that the NEWS score was positively correlated with R and K values (r value was 0.463,0.588, respectively, both P < 0.01), and it was negatively correlated with α angle, MA value and CI (r value was -0.622, -0.689, -0.902, respectively, all P < 0.01). Linear correlation analysis showed that for every 1 minute increase in R value, NEWS score increased by 0.882 [95% confidence interval (95%CI) = 0.691 to 1.073]; for every 1 minute increase in K value, NEWS score increased by 0.484 (95%CI = 0.408 to 0.559); for every 1°increase in α angle, NEWS score decreased by 2.910 (95%CI = -3.325 to -2.494); for every 1 mm increase in MA value, NEWS score decreased by 2.223 (95%CI = -2.488 to -1.958); for every 1 increase in CI, NEWS score decreased by 1.292 (95%CI =-1.362 to -1.221). The R and K values in DIC patients (n = 37) of the severe injury group were significantly higher than those in non-DIC patients [n = 61; R value (minutes): 15.8±5.6 vs. 9.8±2.6, K value (minutes): 7.6±3.1 vs. 4.3±2.2], and α angle, MA value and CI were significantly lowered [α angle (°): 48.7±19.8 vs. 59.6±26.2, MA value (mm):37.5±19.2 vs. 49.2±18.6, CI: -8.5±3.4 vs. -5.2±3.1], the differences were statistically significant between the two groups (all P < 0.05). ROC curve analysis showed that the area under ROC curve (AUC) of the R and K values for predicting DIC was 0.999 and 0.958, respectively. When the optimal cut-off value of R value was 12.3 minutes, the sensitivity and specificity were 97.5% and 100%; when the optimal cut-off value of K value was 5.7 minutes, the sensitivity and specificity were 92.5% and 82.0%. The AUC of α angle, MA value and CI were 0.084, 0.060 and 0.114, which had no predictive value. Conclusions TEG indicators have clinical value on predicting the severity of illness in patients with multiple trauma. The changes in R and K values are effective indicators to judge the risk of DIC in patients with severe multiple trauma.

OBJECTIVE: To investigate the status of anxiety and depression in patients requiring emergency treatment during the epidemic of COVID-19 to identify the patients with acute psychological stress disorder. METHODS: During the COVID-19 epidemic, the medical staff divided the patients visiting the emergency department into suspected group, fever group and control group through interview of the patients at triage. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were distributed to each patient, and a trained medical staff was responsible for assisting the patient to complete the scales. RESULTS: A total of 557 sets of scales were distributed, including 211 in suspected COVID-19 case group, 167 in fever group and 179 in the control group. A total of 516 scales were retrieved, including 197 in suspected case group, 151 in fever group and 168 in control group. In the 3 groups, the incidence rates of anxiety and depression were 57.87% and 58.88%, 48.34% and 43.71%, and 18.31% and 18.99%, respectively, and the rates were significantly higher in suspected group and fever group than in the control group ( < 0.01), and significantly higher in suspected group than in fever group ( < 0.05). The standardized anxiety and depression scale scores in suspected case group, fever group and control group were 57.38±16.25 and 42.58±14.27, 51.23±15.29 and 38.32±15.39, and 32.58±17.8 and 12.25±12.94, respectively. Compared with the control group, both suspected case group and fever group had significantly higher standard scores for anxiety and depression ( < 0.01), and suspected case group had significantly higher standardized scores than fever group ( < 0.01). CONCLUSIONS Among the patients visiting the emergency treatment, the patients with suspected COVID-19 and common fever are more likely to develop anxiety and depressive symptoms.
Anxiety ; epidemiology ; Betacoronavirus ; Coronavirus Infections ; epidemiology ; psychology ; Depression ; epidemiology ; Emergency Service, Hospital ; Humans ; Pandemics ; Pneumonia, Viral ; epidemiology ; psychology