Objective To investigate the prevalence of thyroid nodule(TN)in healthy adults of Yantaishan Hospital.Methods High frequency probe and color Doppler uhrasonography were applied to TN screening in 1125 employees of Yantaishah Hospital.Results In the 1125 adults of Yantaishan Hospital.418 were found to have TN.accounting for 37.2%of all employees.TN incidence increased with age.Thyroid nodule detection rate in female was higher than that in male(40.2%in females and 23.6%in male).The magnitude of the minimum nodule was 2 mm×1 mm in size.13 cases of TN were proved to be thyroid carcinoma.consisting 1.16%of all adults examined.Conclusion The incidence of TN and thyroid carcinoma in Yantaishan Hospital is highcr than that reported in other areas,indicating the necessity of carrying out TN screening among the healthy population.

ObjectiveTo study the effects of dexamethasone local injection as an adjunctive therapy for Hashimoto thyroiditis (HT). Methods60 HT cases were equally divided into 2 groups at random. The patients in the control group were given euthyrpx while the patients in the treated group were injected dexamethasone in addition to the medicine used in the control group. The thyroid characters such as thickness, lymphocytic infiltration and changes of thyroid follicle were observed. The patients were followed up before treatment and 4, 12, 24weeks and 1 year after treatment. ResultsIn the treatment group, all thyroid glands turned significantly softer,and the mass became smaller compared with that in the control group. The pathology of thyroids indicated that lymphocytic infiltration decreased, local immune reaction was ameliorated, and no obvious hormone side effects were observed. ConclusionLocal use of dexamethasone can modify the structure and function of thyroid.

Objective To investigate the minimal inhibitory concentration (MIC) of Pseudomonas aeruginosa to antibacterial agents which were induced by disinfectants.Methods The susceptibility test of 68 strains from clinic was determined by VITEK-2 system.The MIC of povidone iodine,glutaraldehyde and chlorhexidine was determined by agar dilution method.68 strains were induced by different concentrations of three kinds of disinfectants for eight times.The concentration of three kinds of disinfectants was lower than their MIC.The MIC before and after inducement was determined by micro dilution.In the mean-while,strains of their MIC raised to antibiotics were inoculated on plate agar containing the PAβN which was the efflux pump inhibitor,in order to determine the phenotype of efflux pump.Results Six strains,MIC in 68 strains significantly changed after induction of disinfectants.The MIC of these six strains was higher than pre-induced to some antibacterial agents such as FQNs,cephems and carbapenem.The induction of povidone iodine and gilutaraldehyde were more obvious,and five strains,phenotype of efflux pump were positive after being induced by these two disinfectants.Conclusions The antimicrobial susceptibility of some Pseu-domonas aeruginosa will change after being induced by some disinfectants and the efflux pump will play an important role in this process.So the reasonable application of disinfectants were indispensable,in order to decrease the resistance and the opportunity of nosocomial infection.

Objective To study the relation between thyroid nodule and urine iodine and to provide a scientific basis for etiological research of thyroid nodule.Methods 178 cases of thyroid nodule were detected urine iodine concentration (μg/L) by As ( Ⅱ ) 2Ce4 + catalytic spectrophotometry.160 normal people were set as control group.Data of the 2 groups and the correlative clinical information were analyzed.Results The median urine iodine concentration was 116.2 μg/L for the 178 cases of thyroid nodule,217.2 μg/L for the control group.Among the 178 cases,the median urine iodine concentration was 125.6 μg/L for the 92 cases with nodule size ＞ 10 mm and 136.4 μg/L for the 86 cases with nodule size ＜ 10 mm.The difference of urine iodine had no statistical significance between the thyroid nodule group and the control group.There was no correlation between urine iodine and the size of thyroid nodule as well as sex.Conclusions No correlation is found between urine iodine and thyroid nodule.Patients with thyroid nodule,no matter male or female,don't have to restrict iodine intake excessively.

Objective To study the protective effects on ovarian function by caloric restriction (CR) and its mechanism.Methods Thirty female C57BL/6 mice of 8 weeks old were randomly divided into two groups,including ad libitum (AL) group and caloric restriction (CR) group.The general situation and ovarian function of those mice were compared and evaluated.Ovarian follicles were counted by hematoxylin-eosin staining.Anti-Miillerian Hormone(AMH) mRNA expression of the ovary were detected by using real-time PCR.The concentrations of serum estradiol,progesterone of the mice were measured by ELISA.And the fertility of mice by mating trials were evaluated,SIRT3,Hypoxia inducible factor 1α (HIF-1α) and catalase (CAT) mRNA expression of the mice ovaries were detected by Real-Time PCR.Results The total follicles were 546 in CR mice and 286 in AL mice.The proportion of primordial follicles were 38.6％ (211/546)in ovaries of CR mice and 29.4％ (84/286)in ovaries of AL mice,which reached statistical difference.The proportion of atretic follicles 5.3％ (29/546) in ovaries of CR mice,compared with 16.8％ (48/286) in AL mice,was significantly decreased (P ＜ 0.05).The AMH mRNA expression in CR mice ovaries was 3.37 times of that of AL mice (P ＜ 0.05).The serum concentration of estradiol in CR mice was up to (5.3 ± 1.6) pmol/L,which was much higher than (3.6 ± 1.6) pmol/L in AL mice.While,the progesterone concentration of (0.4 ±0.3) nmol/L in CR mice was lower than (1.4 ± 0.8) nmol/L in AL mice (P ＜ 0.05).Fertility and survival of offsprings were both improved in CR mice.The expression level of SIRT3 mRNA in CR mice ovary was 1.39 times,CAT was 1.55 times and HIF-1 α was 0.31 times of those in AL mice (P ＜ 0.05).Conclusions Caloric restriction can delay the ovary aging process through reduce follicle depletion by suppressing follicle recruitment and ovulation.The function of ovarian reserve and reproductive endocrine was effectively protected.Caloric restriction can reduce the incidence of follicular atresia,its mechanism might be associated with anti-oxidative stress.

Objective:To investigate the relationship between serum retinol binding protein (RBP), stromal cell derived factor-1 (SDF-1) and renal function in patients with diabetic nephropathy (DKD).Methods:The patients with type 2 diabetes mellitus (T2DM) admitted to Yantai Affiliated Hospital of Binzhou Medical College from October 2017 to October 2020 were prospectively selected, 438 patients were divided into simple T2DM group ( n=276)and DKD group( n=162) according to the presence or absence of DKD, according to the ratio of urinary albinin/creatinine (UACR) were divided into normal( n=25), microalbuminuria ( n=75) and macroalbuminuria group ( n=62), according to the estimated glomerular filtration rate (eGFR) were divided into G1 stage ( n=28), G2 stage ( n=27), G3A + G3B stage ( n=35), G4 stage ( n=39)and G5 stages( n=33). The relationship between RBP, SDF-1 and renal function index UACR, serum uric acid (UA), blood urea nitrogen (BUN), β 2-microglobulin (β 2-MG) and serum creatinine (Scr) was analyzed. Measurement data of normal distribution were expressed as Mean± standard deviation ( Mean± SD). Independent sample t-test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups.Chi-square test was used to compare the enumeration data between groups. Receiver operating characteristic curve (ROC) was used to analyze the discriminant value of RBP and SDF-1 for DKD. Pearson was used for correlation analysis among indicators. Multivariate linear regression analysis was used to analyze the influencing factors of RBP. Results:In the DKD group, the duration of diabetes was longer, the levels of RBP, UACR, UA, BUN, β 2-MG, Scr were high, SDF-1 and eGFR were lower, with statistically significant differences compared with the simple T2DM group( P<0.05).The areas under the curve of RBP and SDF-1 to distinguish DKD were 0.903 and 0.868, and the optimal cut-off values was 70.71 mg/L and 5.69 ng/mL. With the increase of urinary albumin and clinical stage, the levels of RBP, UACR, UA, BUN, β 2-MG, Scr increased gradually, while SDF-1 and eGFR decreased gradually, and the differences were statistically significant ( P<0.05).RBP was positively correlated with UACR, UA, BUN, β 2-MG and Scr in DKD patients ( r=0.764, 0.787, 0.693, 0.577, 0.801, P<0.000 1), and negatively correlated with EGFR ( r=-0.782, P<0.000 1). SDF-1 was negatively correlated with UACR, UA, BUN, β 2-MG and Scr ( r=-0.744, -0.794, -0.666, -0.605, -0.820, P<0.000 1), and positively correlated with EGFR ( r=0.767, P<0.000 1). The multiple linear regression equation was RBP=29.852+ 0.007UACR+ 0.101UA+ 0.497BUN+ 0.034Scr-0.083eGFR ( P<0.001). Conclusion:RBP and SDF-1 have certain discriminant value for DKD patients in T2DM population, and the degree of DKD renal function injury is positively correlated with RBP and negatively correlated with SDF-1, the increase of UACR, UA, BUN, Scr and the decrease of eGFR are risk factors for the increase of RBP.

Objective To evaluate the effect of dexmedetomidine on the tolerance to endotracheal tube, on agitation and other complications of patients undergoing transnasal transsphenoidal pituitary tumor resection.Methods One hundred and twenty-four patients aged 18-65 years, ASA physical status Ⅰ or Ⅱ) were randomly assigned to dexmedetomidine group (group D, n=60) and control group (group C, n=62).Group D were given intravenous infusion of dexmedetomidine during the operation and group C with saline.The extubation time, observation time in the post-anesthesia care unit (PACU), the incidence of emergence agitation, cough, postoperative sore throat and hoarseness were analyzed.Results The extubation time [(29.7±11.5) min vs (22.2±8.5) min] and the length of stay in PACU [(41.5±11.8) min vs (35.3±10.0) min] were significantly longer in group D than those in group C (P<0.05).There was no significant difference of the incidence of emergence agitation (26.3% vs 32.3%), cough (49.1% vs 53.2%), postoperative sore throat (14.0% vs 24.2%) and hoarseness (10.5% vs 19.4%) between two groups.Conclusion Intraoperative intravenous administration of dexmedetomidine can prolong the extubation time and the length of stay in PACU.The incidence of agitation, cough, postoperative sore throat and hoarseness was not affected by dexmedetomidine.

Objective To explore the correlation between the expression level of interferon gamma(IFN-γ)and the severity of patients with septic shock and its prognostic value.Methods The clinical data and serum of 96 septic shock patients admitted to the Department of Critical Care Medicine,the First Affiliated Hospital of Guangxi Medical University from March 2022 to August 2023 were collected,and divided into survival group and death group according to the 28-day outcome;collected at the same time Sera from 30 healthy people undergoing physi-cal examination during the same period served as the control group.The enzyme-linked immunosorbent(ELISA)method was used to detect the expression levels of IFN-γ in the three groups,and the expression levels of IFN-γ and various clinical data between the groups were analyzed.Results The serum IFN-γ expression level of patients with septic shock was lower than that of healthy people undergoing physical examination,212.80(151.11,255.79)ng/L compared with 343.37(314.5,427.95)ng/L,P<0.01.Among the 96 cases of septic shock,There were 54 cases in the survival group and 42 cases in the death group.The clinical data of the two groups were com-pared.The gender,smoking history,SBP,DBP,SI,Lac,IL-6,IFN-γ,PCT,SOFA score,and APACHEⅡscore of the two groups of patients were compared.The difference is statistically significant(P<0.01).Logistic regression analysis showed that decreased expression of Lac,IFN-γ,and APACHEⅡ score were independent risk factors for death in patients with septic shock.[Odds ratio(OR)and 95%confidence interval(95%CI)were 6.491(1.404～30.004)respectively.0.954(0.954～0.999),3.476(1.210～9.984),P<0.05].The Spearman correlation analysis of INF-γ,Lac and APACHEⅡ showed a negative correlation,and the correlation coefficients were-0.38 and-0.35 respectively.Drawing the ROC curves of Lac,IFN-γ,and APACHEII,the AUCs of the three were 0.847,0.869,and 0.833 respectively.The AUC of the three joint predictions was 0.978.The joint prediction value of the three was better than that of a single indicator,P<0.001.Conclusion The decrease in IFN-γ expression level and the severity of septic shock patients have good prognostic value.

Objective:To investigate the effect of mild hypothermia on macrophage polarization in lipopolysaccharide (LPS)-induced acute lung injury (ALI) mice and to clarify its role in lung injury.Methods:According to a random number table method, 18 male C57BL/6 mice were divided into sham operation group (Sham group), ALI normothermic model group (NT group) and ALI mild hypothermia treatment group (HT group), with 6 mice in each group. The ALI model in mice was established by the method of tracheal instillation of LPS, and temperature control was administered at 1 hour after surgery. The anus temperature in NT group was kept at 36-38?℃, while the anus temperature in HT group was kept at 32-34?℃. The target anus temperature in both groups were maintained for 6 hours and then slowly rewarmed to 36-38 ℃. The Sham group was infused with an equal amount of physiological saline through the trachea without temperature control. After 24 hours of modeling, serum was collected and mice were sacrificed to obtain lung tissue. Pathological changes in lung tissue were observed under light microscopy and semi-quantitative lung injury score was performed. Enzyme linked immunosorbent assay (ELISA) was used to detect the serum levels of interleukins (IL-1β, IL-10). Real-time quantitative polymerase chain reaction (RT-qPCR) was used to test the indicators of macrophage polarization, such as the mRNA expressions of CD86, IL-6, CD206 and arginase 1 (Arg1) in the lung tissue. The protein expression of M1 macrophage marker inducible nitric oxide synthase (iNOS) and M2 macrophage marker Arg1 were detected by Western blotting.Results:Compared with the Sham group, the NT group appeared significant pulmonary hemorrhage and edema, thickened lung septum, inflammatory cell infiltration, and lung injury score was significantly increased; serum IL-1β level was significantly elevated; IL-10 level was increased without statistical significance; the expressions of CD86 mRNA, IL-6 mRNA and iNOS protein were significantly elevated, and CD206 mRNA was significantly decreased; the mRNA and protein expressions of Arg1 decreased, but there were no significant differences. Compared with the NT group, the pathological injury of lung tissue in HT group was significantly reduced, and the lung injury score was significantly decreased (4.78±0.96 vs. 8.56±1.98, P < 0.01); serum IL-1β level was decreased (ng/L: 13.52±1.95 vs. 27.18±3.87, P < 0.01), and IL-10 level was significantly increased (ng/L: 42.59±15.79 vs. 14.62±4.47, P < 0.01); IL-6 mRNA expression was decreased in lung tissue (2 -ΔΔCt: 3.37±0.92 vs. 10.04±0.91, P < 0.05), the expression of M1 macrophage markers CD86 mRNA and iNOS protein were significantly decreased [CD86 mRNA (2 -ΔΔCt): 0.52±0.16 vs. 1.95±0.33, iNOS protein (iNOS/β-actin): 0.57±0.19 vs. 1.11±0.27, both P < 0.05], the expression of M2 macrophage markers CD206 mRNA, Arg1 mRNA and Arg1 protein were significantly increased [CD206 mRNA (2 -ΔΔCt): 3.99±0.17 vs. 0.34±0.17, Arg1 mRNA (2 -ΔΔCt): 2.33±0.73 vs. 0.94±0.23, Arg1 protein (Arg1/β-actin): 0.96±0.09 vs. 0.31±0.11, all P < 0.05]. Conclusion:Mild hypothermia can alleviate the inflammatory response and protect lung tissue in ALI mice, which may be related to the inhibition of M1 macrophage polarization and promotion of M2 macrophage polarization.