The ultrasound part of “2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer” is comprehensive and informative. The content includes the indications for thyroid ultrasound and aspects needed to be evaluated, malignancy risk prediction based on sonographic pattern, decision-making based on ultrasound appearances, follow-up of benign thyroid nodules and surveillance of persistent and recurrent thyroid cancer with ultrasound. Compared with 2009 version of American Thyroid Association (ATA) guidelines, there is a great deal of development. The most important revision was that it analyzed ultrasound pattern of risk stratiifcation of malignancy in thyroid nodules and gave a detailed description of relevant concepts and definitions. Altogether, the new guidelines provided an algorithm for evaluation and management of patients with thyroid nodules based on sonographic pattern and ifne needle aspiration (FNA) cytology. Comprehensive review of the guidelines and appropriate adjustment in practices will make ultrasound examination more reasonable and may enhance the level of medical practices basically..

Objective To investigate the steroid levels of urine in Chinese athletes. Methods Subjects were 1217 Chinese athlete, 8 kinds of steroids named androsterone (An), etiocholanolone (Etio), dihydrotestosterone (DHT), dehydroepiandrosterone (DHET), Testosterone (T), Epitestosterone (ET), 5?-androstane-3?, 17?-diol (5?-diol), 5?-androstane-3?, 17?-diol (5?-diol) were measured by gas chromatography combined with mass spectrometry (GC/MS) after the urine sample being treated with chemical pre-extraction, hydrolysis, extraction and derivatization. Results The urine steroid levels of the Chinese male athlete were higher than those of the female athlete, but both male and female athlete had a lower urine steroids especially testosterone and 5?-androstane-3?,17?-diol, 4～7 times lower than other country's athletes. Some ratios of urine steroids such as An/Etio, T/ET, 5?-diol/5?-diol were relatively steady, which were affected less by gender.

Objective To provide basis of preventing and treating complications by monitoring plasma colloid osmotic pressure and blood clotting function during anesthesia of percutaneous nephrolithotomy (PCNL).Methods 30 patients with upper urinary calculus were equally and randomly divided into two groups according to the different anesthesia method. In General anesthesia group, Midazolam 0. 1 mg/kg、diprivan 1.5mg/kg、Vecuronium bromide 0. 15mg/kg、fentanyl 4μg/kg were used to guide and forane 1 ～ 1.3MAC were used to keep inhalation anesthesia. In lumbar-epidural anesthesia group T12～12 or T12 ～ L1 epidural anesthesia with 0.75% ropivacaine 8 ～ 10 ml and L2～4 lumbar anesthesia with bupivacaine 10mg were used. Plasma colloid osnotic pressure, central venous pressure and TEG were detected at the beginning and at the end of operation and fluid consumption were compared between the two groups. Results There was no obvious difference between the two groups. In both groups ,COP was obviously reduced and CVP was improved after the operation which significantly different with those pre-operation ( all P <0. 01 ). R value reduced significantly(P <0. 05). There were 10 patients complicated with chilling, unconffortability,or anxiety. Conclusion During anesthesia of percutaneous nephrolithotomy, with operation time going on, COP reduced obviously, which increased the risk of heart failure, pulmonary edema, etc. but had no effect on blood clotting.

Scientific and rigorous management system is the prerequisite for specialists to standardize training.In order to cultivate and promote the actual clinical ability,the First Clinical College of Harbin Medical University establish a scientific,reasonable,standard and strict evaluation system in specialist training - the Mini-CEX.This system was employed to test on completion of a course and meet the current medical development of specialist training and evaluation mode.

Objective To make a survey of medication taken by Chinese athletes and a comparison between Chinese athletes and athletes from other countries in order to get information about how to improve Chinese athletes' performance. Method The information came from the forms"Doping Control Sample Collection" in which athletes answered the question: "What medications have you taken in the past 3 days?" The medicines taken by athletes were classified and statistically analyzed.Results 2,330 athletes and 25 kinds of sports were involved in. Medicines were statistically analyzed with 4 classes: profiling of declaration, vitamins and minerals, medicines for treatments, alternative medicine. Conclusion The survey recorded the types of supplements and medications taken by athletes in China in 1999. Chinese athletes took less vitamins and more alternative medicines than athletes from other countries.

Through developing resident standardization training,we established programs of resident standardization training,defined training aims,standardized training items,and established guarantee system,evaluation system,quality-monitoring system and encouragement system,which guaranteed the quality of residency training,and acquired satisfactory effects.

Through approaching the mixed ability training of clinical post-graduates, the following conclusions were drawn: necessity to take turns in the clinical specialties, establishment of its program, the details and contents were pointed out, meanwhile, it is necessary to guarantee progression of the plan and its training effects, and to improve the cultivation quality.

Comprehensively improving the quality of postgraduate education is the main theme of reform and development of postgraduate education. A series of effective measures was taken in the First Affiliated Hospital of Harbin Medical University according to the various aspects of postgraduate education, implementing the whole quality control, enhancing the quality of postgraduate education, in order to accommodate the new situation of postgraduate education.

Objective To investigate the treatment and prognosis of metastatic ovarian carcinoma from gastrointestinal tract. Methods The clinical data of 110 patients with metastatic ovarian carcinoma were reviewed. Results The median age of 110 patients was 45 years old.Metastatic ovarian carcinomas were from stomach (74.5%),and colon and rectum (25.5%).The median overall survival time of 110 patients was 16.3 months,and the median progression-free survival time of 110 patients was 8.2 months.Survival rates of 1-,3-and 5-year were 68.4% 、15.4% and 2.5%,respectively.In univariate survival analysis,different origins(P ＜ 0.01),extent of recurrent disease (P ＜ 0.01),cytoreductive surgery (P ＜0.01),intraperitoneal chemotherapy (P ＜ 0.05) and pathologic type of metastatic ovarian carcinoma (P ＜0.05) were correlated with the prognosis.Age,menstrual history,ascites,and chemotherapy have less effect on prognosis (P ＞ 0.05).In multivariable analysis,different origins (P ＜ 0.01),extent of recurrent disease(P ＜ 0.05) and cytoreductive surgery (P ＜ 0.01) were confirmed to be independent factor. Conclusion Patients with metastatic ovarian carcinomas have poor prognosis.Optimal cytoreduction significantly prolongs overall survival in patients with metastatic ovarian carcinoma from gastrointestinal tract.