Objective To investigate the diagnostic value of ultrasonic elastic strain rate and conventional ultrasound for thyroid nodules,and to guide the clinical treatment.Methods 72 cases,a total of 86 nodules,were treated with ultrasound examination for thyroid nodules and operation were given conventional and ultrasonic elastic strain rate echocardiography before operation, after operation they had a pathological examination for tubercle.The accuracy,specificity and sensitivity of ultrasonic elastic strain rate combined with ultrasound to check the benign and malignant thyroid nodules were analyzed.Results The accuracy of ultrasonic elastic strain rate combined with con-ventional ultrasound was 93.41%,which was significantly higher than 73.67%of the conventional ultrasound (χ2 =12.0,P<0.05) .Conclusion Ultrasound elasticity strain rate combined with conventional ultrasound can effectively differentiate benign and malignant thyroid nodules and improve the accuracy of diagnosis of malignant thyroid nodules, which is conducive to the treatment and prognosis.

AIM: To study factors influencing mannitol to induce blood brain barrier (BBB) opening. METHODS: By constant flow pump, mannitol with different concentration (20% and 25%) was infused into left internal carotid artery of adult Wistar rats via their left external carotid artery at different speed and time. Firstly, after mannitol with a concentration of 25% was transfused, the optimal open time of BBB was investigated using Evans blue as an indicator by injection at different time (0, 2, 4, 6, and 8 min). Then influences of concentration of mannitol, speed of infusion, and change of time on mannitol to induce BBB opening were studied. Finally, death rate was counted according to sex and body weight in order to observe the influence of sex and body weight on tolerance of rats. RESULTS: The open degree of BBB was optimal after 2 min when 3.6 ml mannitol with a concentration of 25% was infused in 30 s at a speed of 0.12 ml?s -1 . However, mannitol with a concentration of 20 % did not almost have any effect on opening of BBB. Slowing of infusion speed or shortening of infusion time of mannitol reduced opening degree of BBB. Body weight affected rat tolerance to mannitol, and the tolerance of the rat was higher in those with higher weight. CONCLUSION: The factors influencing mannitol to induce BBB opening are as follows: concentration, infusion speed, and keeping time of mannitol. And the tolerance to mannitol is not concerned with the sex of the rats, but the body weight of the rats.

OBJECTIVE:To promote safe,effective,economical and proper medication.METHODS:Prescriptions in the outpatient and emergency departments of our hospital in2003were randomly selected;the irrational prescriptions were ana?lyzed with regard to drug descriptions,pharmacological knowledge and literatures.RESULTS:The irrational one amounted to4.92%of the total selected prescriptions;antibiotics drug abuses amounted to84.12%of the irrational ones.The irrational drug use problems were mainly seen in administration scheme,repeated dosage,menstruum,administration,drug combina?tion,compatibility and combined toxicity.CONCLUSIONS:Clinical pharmacist plays an important role in promoting rational drug use by checking prescriptions.

Although osteoporosis is often considered asilent disease,it is highly prevalent.It will definately affect the health of elderly people and bring heavy burden to the society.Studies of osteoporosis will also draw great attention in the field of geriatrics.The diagnosis,treatment,and monitoring of osteoporosis have not yet been standardized.Multidisciplinary medical staff should work together along with the cooperation of the patients.

0.05);The expression of Survivin in hilar cholangiocarcinoma was closely statistically related with the expressions of PTEN and nm23.Conclusion:The expression of Survivin in hilar cholangiocarcinoma is significantly higher than that in tissues near carcinoma,suggesting its correlation with tumor;Survivin plays an important role in the oncogenesis and metastasis of hilar cholangiocarcinoma;Survivin is statistically related with PTEN and nm23 and detected together may helpful for diagnosis and prognosis of hilar cholangiocarcinoma.

Objective To investigate the effect of defecation modes on constipation and anxiety in patients with acute intracerebral hemorrhage.Methods Sixty three conscious patients with acute hintracerebral hemorrhage were recruited in this study.Twenty five patients chose bedside closestool for defecation according their own intention and 38 chose in bed defecation.The incidence of constipation was documented and the severity of anxiety was evaluated with Zung self-rating anxiety scale (SAS) at day 7,14,21 and 28 after admission in two groups.Results Patients using bedside closestool for defecation had significantly lower rate of constipation between day 14-28 after admission (x2 =63.0,P ＜ 0.01) and lower SAS scores at day14,21 and 28 after admission (t =6.7,7.7 and 9.8,all P ＜0.01) than those with in bed defecation.Conclusions The bedside mode of defecation may improve constipation and anxiety in patients with acute intracerebral hemorrhage.

Objective To explore the effect of family doctor contracting service combined with drug therapy on the quality of life of patients with hypertension. Methods Selected in May 2016 to May 2017 in a city in a district of three community health service center clinics diagnosed with hypertension in patients with 840 cases, were given amlodipine besylate tablets treatment, and the implementation of conventional health management And community intervention. According to whether or not to accept the family doctor contract service is divided into observation group (a total of 435 cases) and the control group (a total of 405 cases). Health status questionnaire (SF-36) was used to assess the quality of life before and after the intervention, and the blood pressure control and quality of life improvement were compared between the two groups before and after treatment.Results There was no significant difference in the blood pressure level between the two groups before treatment. The systolic and diastolic blood pressure in the observation group were better than those in the control group (P<0.05). There were no significant differences in physiological function, physiological function, physical pain, general health, mental health, energy, social function, affective function and total score of SF-36 before treatment. The scores of the observation group were significantly higher than those of the control group before and after treatment. The difference was statistically significant (P<0.05). Conclusion Family doctor contract service combined with drug therapy can effectively control the patient's blood pressure levels, improve the quality of life.

Objective To research the current stress status and job stressors of the nurses,and explore the measures of relieving stress.Methods Investigation was carried out in 199 nurses of Qilu hospital by using interviewing and surveying method basing on the literature research.Results 74.4％ nurses work under high even very high stress.Benefit,promotion,workload and time allocation were the first three stressors.Ages,professional titles,education degree,departments were influential factors of stress.49.7％ of the nurses were under high job burnout.Conclusions The nurses are under high work stress and job burnout.There should be measures from environmental level,organizational level,individual level to relieve and manage the stress.

Objective To investigate the elationship between the expression of Cathepsin D and Laminin receptors with the invasion and metastasis of gastric cancers.Methods Cathepsin D and Laminin receptors immunoreactivities were evaluated in 96 patients with gastric cancer using streptavaclin pemxidase method.Results Over expression of Cathepsin D in gastric cancer tissue was significantly related with the depth of invasion,lymphnode metastasis and grade of differentiation (P<0.01,P<0.01 and P<0.05, respectively).Moreover,the high expression of Lamninin receptors in gastric cancer had significant correlations with the invasion depth and grade of differentiation(P<0.05 and P<0.01);The positive expression of Laminin receptors were not significantly related with lymph node metastasis(P>0.05).By statistics analysis Cathepsin D had a significant positive correlation with Laminin receptors (P<0.05). Conclusion Cathepsin D and Laminin Receptors play all important role in the invasion and metastasis of gastric Cancers.