Objective To understand health seeking behaviors and influencing factors among freshmen before enrollment in Kunming Medical University in Yunnan Province and to find out the existing medical problems and provide advice to guarantee undergraduates' seeking proper treatment. Methods We used cluster sampling method to select 1044 freshmen whose last digit of student number was singular and questionnaire was used to do the survey which was conducted within 3 months of admission. Statistical methods were descriptive statistics and multivariate logistic regression analysis. Results The main reasons for students to see the doctor were acute diseases (29.4%) and common disease dominated by cold and fever (34.9%), most of the students went to the medical institutions because of mild medication which can be treated by taking pills. Family location for rural areas had small number of students to see the doctors, the number of students seek medical services with low income families were larger than the high counterparts;students had poor perceived health status tended to seek medical services. Conclusions Family location, incomes and perceived health status are important factors influencing health seeking behavior. The current medical insurance system for college students could be further improved, and colleges and universities should take appropriate measures to provide the conditions for students to seek proper treatment.

Objective To investigate the effects of Gegenqinlian Decoction on the IL-1β level in the patients with chronic periodontitis.Methods Seventy patients with chronic periodontitis were divided into the observation group and control group,35 cases in each group.The control group was given the periodontal basic treatment.On the basis of the control group,the observation group was given Gegenqinlian Decoction.The probing depth,attachment level and bacterial plaque index level before and after treatment were compared between the two groups.The levels of IL-1β and IL-6 in serum and gingival crevicular fluid were measured before and after treatment in the two groups.Results The total effective rate in the observation group was 94.29%,which was significantly higher than 71.43% in the control group,the difference was statistically significant (χ2=6.437,P<0.05).After treatment,the probing depth,attachment level and bacterial plaque index in the two groups were significantly decreased (P<0.05),but which in the observation group were significantly lower than those in the control group,the difference was statistically significant (P<0.05).The levels of IL-1β and IL-6 in serum and gingival crevicular fluid after treatment in the two groups were decreased significantly (P<0.05),but which in the observation group were significantly lower than those in the control group,the difference was statistically significant (P<0.05).Conclusion Gegenqinlian decoction can significantly reduce the IL-1β level in the patients with chronic periodontitis,reduces inflammation reaction and improves the therapeutic effect.

Objective To investigate the relationship of the cytogenetic abnormalities detected by FISH in patients with MM and their clinical features. Methods FISH on bone marrow (BM) cells was performed in 57 enrolled MM patients. Relationships between cytogenetic abnormalities and clinical features were analyzed. Results By statistical analysis , both D13S319 deletion and RB1 deletion were associated with high level of serum LDH (P = 0.024; P = 0.018) and BM plasma cells index (P = 0.027; P = 0.013). 1q21 amplification was significantly associated with high level of LDH (P = 0.030 ) and the occurence of light chain type myeloma (P = 0.023). IgH rearrangement was associated with renal function damage (P = 0.009). There were correlations among D13S319 deletion, RB1 deletion, 1q21 amplification and IgH rearrangement (P<0.01). Conclusion The genetic abnormalities detected by FISH in patients with MM were correlated with various clinical poor prognostic indicators, which can evaluate the condition and prognosis of patients more efficiently.

Objective To investigate the application of intraoperative neuromonitoring (IONM) during thyroidectomy for external branch of superior laryngeal nerve(EBSLN).Methods From Jan.2017 to Jun.2017,138 patients undergoing thyroidectomy were randomly divided into monitor group (n=69) and the control group (n=69).The monitor group were used IONM for EBSLN,while the control group were used conventional area protection.Results The overall incidence of EBSLN injury was 1.4％(1/69) in the monitor group,and the overall incidence of EBSLN injury was 11.6％(8/69) in the control group.There was statistical significance between the two groups.Conclusion The application of IONM in thyroidectomy can exactly identify EBSLN,and reduce the possibility of EBSLN injury remarkably.

Objective To clarify the role of BRAFV600E and TERT promoter mutations in cervical lymph node metastasis in papillary thyroid carcinoma.Methods The data of 432 patients with thyroid papillary carcinoma who underwent surgery from February 2017 to September 2017 at the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.The mutation of BRAFV600E and TERT promoter was detected by Sanger sequencing.The effect of BRAFV600E and TERT on cervical lymph node metastasis in patients with papillary thyroid carcinoma was analyzed by Chi-square test.Results The mutation rates of BRAFV600E and TERT promoter were 77.8％ (336/ 432) and 5.3％ (23/432) respectively in 432 papillary thyroid carcinoma patients.The probability of cervical lymph node metastasis in patients with BRAFV600E mutation was significantly higher than that in non-mutation patients (P ＜ 0.05).The probability of cervical lymph node metastasis in patients with TERT promoter mutation was significantly higher than that in non-mutated patients (P ＜ 0.05).Patients with both BRAFV600E and TERT promotermutation had a significantly higher incidence of cervical lymph node metastases than patients with the BRAFV600E mutation alone (P ＜ 0.05).Conclusions The mutations of BRAFV600E and TERT promoter are closely relevant to the occurrence of cervical lymph node metastasis in papillary thyroid carcinoma.Preoperative fine-needle aspiration cytology and postoperative routine pathological molecular diagnosis can help clinicians to develop a more rational treatment strategy,and a more accurate assessment of the risk of relapse.

Objective To evaluate the relationship between clinicopathological features and central lymph nodes metastasis in patients with papillary thyroid microcarcinoma (PTMC),and aim to provide an appropriate operation in clinic.Methods The clinical data of 536 patients undergoing surgical treatment in Department of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2017,who had pathologically confirmed popillary thyroid microcarcinoma (PTMC) were retrospectively analyzed.Thyroidectomy and isthmectomy with central compartment neck dissection were performed in all patients.The patients were divided into two groups according to whether there existed central lymph node metastasis,and compared the differences of gender,age,number of cancer lesions,tumor breakthrough envelope,BRAFV600E gene mutation,and tumor maximum diameter in the central lymph node metastasis,respectively,by t-test x2-test.Univariate logistic regression analysis and multivariate binary logistic regression analysis were conducted to find risky factors.Results There existed difference between two groups by completing the gender,age,the BRAFV600E gene mutation and maximal tumor diameter(P ＜ 0.05).Univariate logistic regression analysis indicated that gender (P =0.046),age (P ＜ 0.01),maximal tumor diameter(P ＜0.01) and the BRAFV600E gene mutation(P =0.016) were significant predictors for central lymph nodes metastasis.And multivariate binary logistic regression analysis revealed that the rate of lymph node metastasis significantly increased in cases of larger tumor diameter(P ＜0.01),BRAFV600E gene mutation(P =0.035) and ageing below 45 years old (P ＜ 0.01).Conclusions The treatment for central lymph node metastasis of PTMC should be different considering elements including BRAF600E gene mutation prophylactic,ageing below 45 years old and larger tumor diameter.Therefore central lymphadenectomy should be performed when the primary lesion was resected.

Objective: To summarize the clinical manifestations and treatment of retinal artery occlusion and cerebral infarction caused by facial injection of hyaluronic acid. Methods: Fifteen cases (15 eyes) with vision lose caused by facial cosmetic injection of hyaluronic acid visited Xi＇an No.4 Hospital from December 2010 to January 2017. The clinical data were collected such as general medical history and treatment methods, and follow-up for 1 year. Results: All patients were female, 22-41 years old, with average age of 33. All patients were injected with hyaluronic acid. For 8 patients the fillers were injected in the forehead, 3 patients were in the glabellar region, 3 patients were in the nasolabial fold, and 1 patient was in the temporal of left eye. All patients had vision lose after injection, the visiting time was 1 to 6 hours. 13 patients were central retinal artery occlusion (CRAO). 1 patient was retinal branch artery occlusion (BRAO), 1 patient was ischemic optic neuropathy (ION), 13 patients manifested as no light perception (NLP), 1 patient was 0.6, 1 patient was CF/30 cm, and 14 patients with cerebral infarction, manifested as headache, dizziness. All patients were given emergency treatment, and 9 patients had treated with interventional thrombolysis therapy. After treatment 11 patients, visual acuity had no significant improvement, but 4 patients improved. Headache, dizziness symptoms disappeared, but cerebral infarction lesions still existed on MRI. Conclusions Human face is a rich blood supply; vision loss and cerebral infarction could occur after injection of hyaluronic acid. After urgent treatment visual acuity is not improved obviously, eventually leading to irreversible visual impairment or even loss.

Objective To analyze the clinical characteristics of C-TI-RADS 3 thyroid nodules with a diameter greater than 2 cm and explore their correlation with gender,nodule ingredient,contralateral cancer presence,diffuse echo changes,TPOAB and TGAB.Methods A retrospective analysis was made on the clinical and pathological information of 94 patients with thyroid nodules who were admitted to our department from September 2022 to March 2023.All the patients underwent cytological and/or histopathological examinations.The proportions of TBS I category,benign tumors,low-risk tumors,and malignant tumors were calculated.The proportion of TBS type Ⅰ,benign tumors,low-risk tumors,and malignant tumors was quantified.Subsequently,a comparative analysis was conducted among the benign,low-risk,and malignant groups in terms of clinical characteristics including gender distribution,nodule composition,contralateral cancer occurrence,diffuse echo changes presence,as well as TPOAB and TGAB levels.Results Seven cases in TBS I category were excluded.Among the remaining 87 cases with confirmed pathology results for nodules,there were 72 benign cases(38 cytology cases and 34 histology cases),5 low-risk thyroid tumors(2 cytology cases and 3 histology cases),10 malignant cases(8 PTC cases,1 FTC case,and 1 MTC case).There was a significant difference in nodule ingredient(cystic/solid)between different pathological types(x2=10.369,P=0.006).However,no statistical significance was found in terms of gender,diffuse echo changes,contralateral cancer presence,TPOAB or TGAB(P＞0.05).Further analysis showed that the proportion of solid component was higher in low-risk tumors than in benign nodules(x2=9.571,P=0.002).No statistical significance was found between malignant nodules and low-risk nodules(x2=2.143,P=0.143),or between malignant nodules and benign nodules(x2=2.165,P=0.141).Conclusion Although TI-RADS 3 nodules are generally considered as potentially benign according to various versions of thyroid imaging reporting and data system,malignant nodules still account for a certain proportion.Attention should be paid to thyroid nodules with a typical ultrasonic signs,such as cystic nodules,thyroid follicular tumors and medullary thyroid carcinoma.Ultrasound guided fine needle aspiration cytopathology is necessary for evaluating benign and malignant nodules.It is necessary to pay attention to unsatisfactory or undiagnosable specimens to improve the accuracy of diagnosis.