Objective To explore the value of spiral CT in differentiation between benign and malignant thyroid tumor.Methods CT findings of thyroid tumor confirmed by the pathology in 50 patients,were retrospectively analyzed and in comparison with the data of operation and pathology.Results There were benign tumor(n=35)and malignant tumor(n=15)in this study.All the benign tumors were thyroid adenoma.The malignant tumors included thyroid carcinoma(n=14)and lymphoma(n=1).All the cases of thyroid benign tumors demonstrated clear margin and homogeneous enhancement.Cystic area and curvilinear or mass calcification could be seen in some cases.Some characteristic signs,such as irregular tumor outline,fine discrete granular and irregular calcification,heterogeneous enhancement,invading neighbor structures and cervical lymph node metastasis,could only been seen in thyroid malignant tumors.Conclusion Spiral CT has a notable advantage in differential diagnosis between benign and malignant thyroid tumor.

Objective To analyze the early renal function of donors after nephrectomy.Methods Clinical data of 467 cases of living kidney donors during the period from April,2010 and November,2014 in our center were retrospectively analyzed.Data on serum creatinine (Scr),glomerular filtration rate (GFR),serum uric acid (UA),and urine microproteins before operation and three days,seven days,one month and three months after operation were collected to evaluate the impact of nephrectomy on early renal function after operation for donators.Results Before operation and three days,seven days,one month,three months after operation,the average serum creatinine (Scr) level was (59.9±12.8),(85.8±21.0),(91.2±21.3),(92.8±21.6),(91.0±21.3) μmol/L,respectively; The GFR were (113.5±25.3),(75.1± 17.9),(70.3± 15.2),(68.5± 16.0),(69.5± 15.1) ml/min,respectively; The levels of uric acid were (292.60±79.58),(142.18±55.28),(228.41±66.39),(321.31± 83.72),(346.61±87.21) μmol/L,respectively; All these data above-mentioned after operation reached statistical significance compared with that before operation (P ＜ 0.05).Parameters including urine IgG,urine albumin,urine retinol-binding protein and urine β2-microglobulin post-operation time point were significantly different when compared with relative parameters pre-operation (P ＜ 0.05).Conclusions Nephrectomy has significant influence on GFR,uric acid,and urine microprotein for donors in the early stage after operation.It's worth to evaluate nephrectomy's long-term effect on the renal function of donors in clinical practice.

Objective:To investigate the effect of nursing profession practice model on key competence of intravenous therapy specialized nurses.Methods:A total of 30 nurses were selected in People`s Hospital of Wanning by using professional practice model. The effect of key competence and intravenous therapy-related adverse events were evaluated.Results:Before training, the scores of professional attitude, professional theoretical knowledge, professional practical skills, critical thinking ability, and communication and coordination ability, nursing management ability, professional development ability were (2.74±0.66) points, (2.28±0.57) points, (2.62±0.48) points, (2.52±0.32) points, (2.38±0.38) points, (2.68±0.70) points, (2.32±0.48) points. After training, those scores were (4.02±0.88) points, (4.10±0.60) points, (3.97±0.61) points, (3.69±0.38) points, (3.78±0.60) points, (4.07±0.87) points, (3.86±0.69) points, the differences were statistically significant ( t values were 6.542-12.226, P<0.05). The incidence of phlebitis, transfusion reaction, transfusion leakage, unplanned extubation, catheter-related infections in 2016 were 0.28% (53/18 731), 0.17% (31/18 731), 0.19% (35/18 731), 0.05% (10/18 731), 0.33% (62/18 731), those adverse events were 0.12% (37/23 183), 0.07% (17/23 183), 0.09% (20/23 183), 0.01% (3/23 183), 0.19% (45/23 183) in 2018, the differences were statistically significant ( χ2 values were 5.466-15.074, P<0.05 or 0.01). Conclusion:Nursing professional practice model can promote the key competence of intravenous therapy specialized nurses and decrease the incidence of intravenous therapy-related adverse events.

Objective To investigate the rate of hippocampus injury during whole brain radiotherapy for intracranial metastasis and explore the effect of whole brain radiotherapy in reducing the radiotherapy induced neurocognitive dysfunction of hippocampu and provide reference for the treatment of intracranial metastatic tumors. Methods The intracranial metastases in 123 patients from January 2015 to December 2016 were enrolled in this study. The MRI image data before and after radiotherapy were analyzed retrospectively.The anatomical position of tumor and the hippocampus in patients with intracranial metastasis was outlined.According to outlined position, the relationship between location of intracranial metastatic tumor and the hippocampus was analyzed, and the probability of the hippocampal damage by tumor radiotherapy was calculated in the treatment of intracranial metastatic brain. Neurocognitive dysfunction improvement by protective irradiation of hippocampus was compared between different radiotherapy methods. Results Four hundred and seventeen intracranial metastatic tumors were observed in 123 patients, among which the sites of 15 tumors(3.60%) were within the 5mm of hippocampus, the sites of 146 tumors(35.01%)were 5-10 mm from the hippocampus, and the sites of 256 tumors(61.39%) were beyond 10 mm of hippocampus. The distribution of 417 metastatic tumors in the brain was as followings: 137 tumors (32.85%) were in frontal lobe, 98 tumors(23.50%) were in temporal lobe, 59 tumors(14.15%)were in parietal lobe, 46 tumors(11.03%)were in occipital lobe, 41 tumors (9.83%) were in cerebellum and 36 tumors (8.63%) were in basal ganglia. Using helical tomotherapy, intracranial metastasis radiotherapy and volumetric modulated arc radiotherapy, the rate of patients with cognitive dysfunction induced by hippocampal injury was 1.96%(1/51), 10.26%(4/39)and 18.18% (6/33), and there was significant difference (χ2= 6.595, P = 0.000). Conclusions The hippocampus injury possibility is very small, when whole brain radiotherapy is used in the treatment of intracranial metastatic tumors. Avoiding the hippocampus in radiation therapy of intracranial metastasis has high feasibility, among which the helical tomotherapy can effectively reduce hippocampus injury and improve patients'cognitive function.

Objective:To investigate the clinical value of serum cystatin C(Cys C) and neutrophil gelatinase associated lipocalin(NGAL) combined with cardiac biomarkers in the evaluation of sepsis with renal injury in children.Methods:The clinical data of 130 children with sepsis(67 cases in sepsis non AKI group and 63 cases in septic AKI group)admitted to pediatric intensive care unit(PICU) at Hunan Children′s Hospital from May 2018 to December 2019 were retrospectively analyzed.The differences of serum Cys C, NGAL and cardiac related biomarkers between sepsis and septic kidney injury were analyzed and compared.Results:The levels of serum Cys C, NGAL and amino-terminal pro-brain natriuretic peptide(NT-proBNP) in children with septic AKI were significantly higher than those in children of sepsis non AKI group(all P<0.01). There were no significant differences in creatine kinase isoenzyme(CK-MB)and high-sensitivity troponin T(cTnT-hs) between two groups (all P>0.05). The levels of CK-MB, cTnT-hs, NT-proBNP, Cys C and NGAL in the dead children were significantly higher than those in the surviving children ( P<0.05). In terms of predicting of AKI, the area under the ROC curve of NGAL, Cys C and NT proBNP were 0.724, 0.759 and 0.747, respectively.Regarding predicting the survival and death of sepsis, the area under the ROC curve of NGAL, Cys C and NT proBNP were 0.719, 0.722 and 0.769, respectively.In predicting the prognosis of children with sepsis and kidney injury, the area under the ROC curve of NGAL, Cys C and NT proBNP were 0.683, 0.651 and 0.682, respectively.The binary Logistic regression equation was established by Cys C, NGAL and NT-proBNP, Y=0.970 NGAL+ 0.9441 BNP+ 1.815 Cys C-2.944.In predicting kidney injury, evaluating prognosis of sepsis and predicting prognosis of sepsis with kidney injury, the area under ROC curve of new variable Y were 0.882, 0.802 and 0.808, respectively. Conclusion:NGAL, Cys C and NT-proBNP can be used to judge sepsis and sepsis with kidney injury alone.The evaluation value of combined detection of three indexes is better than that of single index.Therefore, the combined use of the three indicators may be better to judge the condition of children with sepsis and kidney injury.

The "self and mutual service" is a novel and diverse civil provision model for the aged. As a supplement to social resources for the aged, it is a promising in development. This article reviews the status quo of mutual provision for the aged in China's urban communities, aiming to make feasible proposals for the healthy development of China's mutual provision for the aged.

The existing researches on scraping mostly focus on the observation of curative effect and preliminary attempts to explore the mechanism of action, but the research on scraping manifestation is slightly insufficient. At present, scraping manifestation studies mainly include skin appearance, skin blood perfusion, and skin temperature. These studies have laid the foundation and provided a reference for the standardization, normalization, and visualization research of scraping technology in the future. However, these studies are still in their infancy and need to be further studied.

Objective To analyze the hotspots and frontiers of researches related to pain in Parkinson's disease. Methods The literatures on pain in Parkinson's disease were retrieved from CNKI,VIP,Wanfang data,CBM and Web of Science Core Collection from inception to November,2023,and were analyzed with CiteSpace 6.1.R6. Results A total of 926 literatures were included with 293 in Chinese and 633 in English,respectively.Chinese high-fre-quency keywords were quality of life,sleep disorders and depression,while English high-frequency keywords were nonmotor symptom,quality of life and levodopa.The latest bursting word in Chinese was pathogenesis,while the latest bursting words in English were exercise and management. Conclusion Number of researches related to pain in Parkinson's disease is gradually rising,and the characteristics,patho-genesis,quality of life,rehabilitation interventions and clinical efficacy have become research hotspots.The mechanism of pain in Parkinson's disease and rehabilitation management program will be the main research top-ics in the future.

Objective To define the traditional Chinese medicine (TCM) nursing core knowledge and practical ability which nurses should be equipped with when carrying out TCM service so as to provide a reference for the training of nursing talents of TCM at home and abroad. MethodsOn the basis of establishing a research group, a questionnaire was formed based on literature research, university research, brain storm and expert interviews. A total of 76 TCM nursing experts from universities and hospitals at home and abroad of TCM were investigated with the questionnaire to form an expert consensus. ResultsA total of 76 questionnaires were issued in this survey, of which 64 were valid.This study formed the core knowledge and practical ability training standard including three course modules of basic courses of TCM, basic courses of TCM nursing and specialized courses of TCM nursing, and 9 courses of basic theory of TCM, diagnosis of TCM, science of Chinese materia medica, pharmacology of TCM, fundamental of TCM nursing, TCM diet therapy, acupuncture and moxibustion and nursing, TCM nursing skill operation, TCM nursing clinical practice. ConclusionsThe standard could provide a basis for the standardized teaching of TCM nursing, establishment of training module, formulation of training plan and evaluation of talent training quality.

Objective:To observe the clinical effect of scraping therapy on lumbar disc herniation (LDH) with different syndromes.Methods:Using the convenient sampling method, a total of 30 non-emergency LDH patients who were admitted to Department of Orthopedics and Traumatology of Yangzhou Hospital of Traditional Chinese Medicine from July 2017 to June 2018 were selected as the research objects. Among them, there were 11 cases of qi stagnation and blood stasis syndrome, 8 cases of damp-heat obstruction syndrome, 7 cases of cold-damp obstruction syndrome and 4 cases of liver and kidney deficiency syndrome. Du meridian, the bladder meridian of Foot Taiyang, as well as Jiaji (EX-B2) in pathological or painful sections, Ashi point, Shenshu (BL 23) , and Weizhong (BL 40) were mainly scraped. The treatment interval is 2~5 days (the marks of scrapping fade) , twice of scrapping as a treatment course and a total of 3 courses involved in the whole treatment. Japanese Orthopaedic Association (JOA) Score, Visual Analogue Scale (VAS) , serum interleukin-1 β (IL-1β) and interleukin-10 (IL-10) were compared before and after scraping.Results:Compared with those before scraping, the JOA score increased, the VAS decreased, the serum IL-1β content decreased and the serum IL-10 content increased after scraping, and the differences were sttaistically significant ( P<0.01) . Among them, the JOA scores of patients with qi stagnation and blood stasis syndrome and cold-damp obstruction syndrome were higher than those of damp-heat obstruction syndrome and liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . The levels of serum IL-10 in patients with qi stagnation and blood stasis syndrome, damp-heat obstruction syndrome and cold-damp obstruction syndrome were higher than those in patients with liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . Conclusions:The curative effect of scraping in the treatment of LDH is definite, and the curative effect is better for excessive syndromes.