Objective To detect serum levels of thyroid hormones in patients with thyroid nodules (TN), and investi-gate their relationship with the nature of TN. Methods A total of 245 patients with TN were recruited in the study. Accord-ing to levels of thyroid antibodies and postoperative pathological results, all patients were divided into nodular goiter (NG) group, thyroid adenoma (TA) group and thyroid cancer (TC) group. TC group was further classified as the TC with increased level of thyroid antibodies (TC-AB+group) and the TC with normal level of thyroid antibodies (TC-AB-group). The serum levels of free T3 (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH) were detected for all patients before operation, and differences of thyroid hormones were analyzed between different groups. Results The serum level of TSH was signifi-cantly higher in TC group than that of NG group and TA group (P<0.05). The serum level of FT3 was significantly lower in TC-AB+group than that of NG group and TC-AB-group. The serum level of FT4 was significantly lower in TC-AB+group than that of NG group, and the serum TSH level was significantly higher than that of other groups (P<0.05). Conclusion The increased serum levels of TSH were found in some patients with TC, which may partly attribute to their coexistence with autoimmune thyroiditis and subsequent hypothyroidism. The increased serum TSH level may not be the inherent characteris-tics of TC.

Objective To investigate the relationship between inflammation and blood coagulation function in the patients with acute exacerbation of chronic cor pulmonale (AECCP) and discuss the potential mechanism and influence on the patients. Methods The present study was based on 30 healthy controls and 141 cases of AECCP in our hospital from January 2011 to June 2014.Levels of white blood cell (WBC), neutrophil (NEUT), high-sensitivity C-reactive protein (hs-CRP, Complement 3 (C3), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) in the patients were determined. Results Compared with the healthy controls, the patients had higher levels of WBC, NEUT, hs-CRP, PT, APTT, FIB, TT (all P < 0.001) and lower level of C3 (P < 0.001). Significant positive correlations were found between the levels of WBC, NEUT and FIB (r = 0.196 and r = 0.199, both P < 0.05); hs-CRP and APTT, FIB(r = 0.234, P < 0.01 and r = 0.466, P < 0.001); C3 and FIB(r = 0.466, P < 0.001), and significant negative correlations were observed between the levels of C3 and PT, APTT, TT (r=-0.258, P<0.01;r=-0.279, P < 0.01 and r = -0.168, P < 0.05, respectively). Compared with the survival patients, the cases of death had higher levels of WBC and NEUT (both P < 0.01). The area under receiver operating characteristic curve of WBC and NEUT, predicting the prognosis, was 0.666 (95% CI 0.552, 0.780; P < 0.01) and 0.695 (95% CI 0.558, 0.801; P = 0.001) respectively. Conclusions Inflammation and blood coagulation function disorder usually coexist in the patients with AECCP, and are closely associated with the severity. Levels of both WBC and NEUT can be used as prognosis predictors for the patients.

Objective To study the effect of scenario case based learning for nurse-patient communicationon empathy of un-dergraduate nursing students. Methods The undergraduate nursing students who had completed the basic nursing courses and the course of"communication in nursing"were enrolled as participants.Seventy-two students recruited in 2013 were assigned as the control group,where only individual guidance was given before taking examination;while eighty-nine students recruited in 2014 as the inter-vention group,where a self-compiled Collection of Scenarios for Nurse-Patient Communication was given when they were preparing for the final examination and the students were required to give their own communication plans based on the scenario cases from the collec-tion.The two groups were compared in view of empathy. Result The intervention group were better in empathy ability assessment, with statistically significant difference (P<0.001). Conclusions The scenario case based learning for nurse-patient communication makes up for the shortcomings of traditional teaching methods.It encourages nursing students to think from the patients'perspective and improves the empathy ability of students.

Objective: To investigate the current status of occupational stress in medical staff in Shenzhen, China, and to provide a reference for developing health administrative policy and reducing occupational stress in medical staff. Methods: From January to June, 2018, a cross-sectional survey was performed in 992 medical workers who were selected from 2 municipal hospitals and 2 district hospitals by stratified random sampling. General information was collected, Occupational Stress Inventory-Revised Edition was used to investigate occupational stress, and univariate and multivariate analyses were performed based on a descriptive analysis of related results. Results: For the medical staff in Shenzhen, the scores of Occupational Role Questionnaire, Personal Stress Questionnaire, and Personal Resources Questionnaire were 185.67±17.55, 108.45±15.56, and 122.74±16.56, respectively. Age, degree of education, type of work, job title, professional title, and permanent or temporary job were influencing factors for occupational task (P<0.05) ; age, working years, type of work, and night shift were influencing factors for personal stress response (P<0.05) ; working years, type of work, professional title, and weekly working hours were influencing factors for personal coping resources (P<0.05) . Conclusion There is a high degree of occupational stress among medical staff in Shenzhen, and it is recommended to improve medical resources in Shenzhen, reduce occupational stress among medical staff, and increase coping resources.

OBJECTIVE: To investigate the current status of occupational stress and quality of life( QOL) in medical staffs of Shenzhen City. METHODS: A total of 992 medical stuffs from 4 hospitals of Shenzhen City were selected as study subjects by using the stratified random sampling method. The Occupational Stress Inventory Revised Edition and SF-36 Questionnaire were used to investigate the occupational stress and QOL. RESULTS: The rate of high occupational strain in medical staffs of Shenzhen is 48. 8%. According to the results of multivariate stepwise regression analysis,the influencing factors for physical component summary of QOL were profession,education,occupational strain,personal coping resource,length of service and work hours( P < 0. 05). The influencing factors of mental component summary of QOL were age,occupational strain,personal coping resource,length of service,work hours and gender( P < 0. 05). CONCLUSION: Occupational stress is a factor influencing the physical and mental health of medical staffs in Shenzhen City. High occupational stress and lack of coping resources can reduce the QOL.

Objective:To explore the methods and clinical effects of the surgery for treating maxillary medication-related osteonecrosis of the jaw (MRONJ).Methods:The clinical data including gender, age, stage of lesion, treatment method and prognosis of 28 patients with maxillary MRONJ who underwent surgical treatment in the Department of Oral and Maxillofacial Surgery of Medical School of Nanjing University from January 2013 to October 2020 were retrospectively analyzed. There were 20 males and 8 females. The mean age at onset was (65.6±11.1) years old. According to the guidelines of American Association of Oral and Maxillofacial Surgeons, the patients′ lesions were divided into 2 or 3 stages. Ten cases of stage 2 lesions were tightly sutured after partial jaw resection. Among them, 4 lesions were sutured directly with mucoperiosteal flaps, 4 lesions were covered by adjacent flaps and 2 lesions was covered by buccal fat pad flaps and adjacent flaps. Eighteen cases of stage 3 lesions were treated with sequestrectomy and drainage channels were formed. Patients were followed up regularly after the surgery, and the effect of surgical treatment was judged according to the clinical criteria such as clinical manifestations, local oral examination, imaging examination etc.Results:After follow-up for 12 to 52 months, the postoperative pain score (1.20±2.53) was significantly lower than preoperative pain score (6.70±0.95) ( P<0.05) in stage 2 patients. Eight patients′ mucosa healed completely without new dead bone formed. Two patients had recurrence and developed to stage 3 at the time of revisit. There were 18 cases of stage 3 lesions, which formed drainage channels after removal of the dead bone. The postoperative follow-up time was 2 to 67 months, and the symptoms of inflammation and infection disappeared. Postoperative pain score (3.40±0.51) was significantly lower than preoperative pain score (7.06±1.00) ( P<0.05). Conclusions:Soft tissue flap closure of wound after partial maxillectomy is an effective approach for the treatment of maxillary MRONJ stage 2 lesions, while maxillary stage 3 lesions could be treated for eliminating clinical symptoms and improving the quality of life when establishing unobstructed drainage after dead bone extraction.

OBJECTIVE To systematically evaluate the adverse effects of drug-resistant tuberculosis （DR-TB） drugs on pregnant women and fetuses ，so as to provide evidence-based reference for clinical medication. METHODS PubMed，Cochrane Library，Embase，CBM，CNKI，Wanfang database and VIP were searched by computer to collect randomized controlled trials （RCTs），cohort studies ，case-control studies ，case series and case reports about pregnant women exposed to DR-TB drugs. The retrieval time limit was from the establishment of each database to August 20，2021. After selecting the literature and extracting the data，the bias risk assessment tool recommended by 6.2 version of Cochrane system evaluator manual was used to evaluate the quality of the included RCTs ；Newcastle-Ottawa scale was used to evaluate the quality of the included cohort studies and case-control studies ；IHE scale issued by the Canadian Institute of Health Economics （IHE）was used to evaluate the quality of the included case series and case reports. RevMan 5.1 software was used for Meta-analysis of non-comparative binary data. RESULTS A total of 13 literature were included ，including 7 case series and 6 case reports ，involving 203 patients and 204 newborns；among them，there were 6 literature about non-comparative binary data. The results of meta-analysis showed that after exposure to DR-TB drugs，no newborn had birth defects ；the mortality of pregnant women was 0.09[95％CI（0.06，0.15），P＜0.000 01]；the neonatal mortality was 0.02[95％CI（0，0.06），P＜0.000 01]；the incidence of preterm birth was 0.14[95％CI（0.03，0.43），P＝0.02]；the incidence of infants with low birth weight was 0.17[95％CI（0.04，0.51），P＝0.06]；the incidence of growth retardation was 0.15[95％CI（0.09，0.22），P＜0.000 01]；the incidence of stillbirth was 0.05[95％CI（0.02，0.09），P＜0.000 01]；the incidence of abortion was 0.08[95％CI（0.05，0.14），P＜0.000 01]. CONCLUSIONS Pregnant women exposed to DR-TB drugs can cause pregnant women ’s death and abortion ，neonatal death ，premature birth ，infants with low birth weight ，growth retardation and stillbirth，but there is no neonatal birth defect ；these adverse outcomes may be related to the history of DR-TB.

OBJECTIVE To summarize the current situation of pharmaceutical clinic service in our hospital over the past five years， and explore sustainable development strategies for service models of pharmaceutical clinics. METHODS A retrospective analysis was conducted on the consultation records of patients who registered and established files at the pharmaceutical clinic in our hospital from January 2019 to December 2023. Statistical analysis was performed on patients’ general information， medication- related problems， and types of pharmaceutical services provided by pharmacists. RESULTS A total of 963 consultation records were included， among which females aged 20-39 years accounted for the highest proportion （66.04%）； obstetrics and gynecology- related consultations accounted for the largest number of cases. Additionally， 80 patients attended follow-up visits at our hospital’s pharmaceutical clinic. A total of 1 029 medication-related issues were resolved， including 538 cases of drug consultations （52.28%）， 453 medication recommendations （44.02%）， 22 medication restructuring（2.14%）， and 16 medication education （1.55%）； the most common types of medication-related problems identified were adverse drug events（70.07%）. CONCLUSIONS Although the pharmaceutical clinic has achieved recognition from clinicians and patients， challenges such as low awareness among healthcare providers and the public persist. Future efforts should focus on strengthening information technology construction， enhancing pharmacist training， and establishing various forms of outpatient pharmaceutical service models.

Background Bacteria are the most diverse and widely sourced microorganisms in the indoor air of subway stations, where pathogenic bacteria can spread through the air, leading to increased health risks. Objective To understand the status and distribution characteristics of indoor air bacterial pollution in subway stations and compartments in a city of Central South China, and to provide a scientific basis for formulating intervention measures to address indoor air bacteria pollution in subways. Methods Three subway stations and the compartments of trains parking there in a city in Central South China were selected according to passenger flow for synchronous air sampling and monitoring. Temperature, humidity, wind speed, carbon dioxide (CO₂), fine particulate matter (PM_2.5), and inhalable particulate matter (PM₁₀) were measured by direct reading method. In accordance with the requirements of Examination methods for public places-Part 3: Airborne microorganisms (GB/T 18204.3-2013), air samples were collected at a flow rate of 28.3 L·min⁻¹, and total bacterial count was estimated. Bacterial microbial species were identified with a mass spectrometer and pathogenic bacteria were distinguished from non-pathogenic bacteria according to the Catalogue of pathogenic microorganisms transmitted to human beings issued by National Health Commission. Kruskal-Wallis H test was used to compare the subway hygiene indicators in different regions and time periods, and Bonferroni test was used for pairwise comparison. Spearman correlation test was used to evaluate the correlation between CO₂ concentration and total bacterial count. Results The pass rates were 100.0% for airborne total bacteria count, PM_2.5, and PM₁₀ in the subway stations and train compartments, 94.4% for temperature and wind speed, 98.6% for CO₂, but 0% for humidity. The overall median (P₂₅, P₇₅) total bacteria count was 177 (138,262) CFU·m⁻³. Specifically, the total bacteria count was higher in station halls than in platforms, and higher during morning peak hours than during evening peak hours (P<0.05). A total of 874 strains and 82 species were identified by automatic microbial mass spectrometry. The results of identification were all over 9 points, and the predominant bacteria in the air were Micrococcus luteus (52.2%) and Staphylococcus hominis (9.8%). Three pathogens, Acinetobacter baumannii (0.3%), Corynebacterium striatum (0.1%), and Staphylococcus epidermidis bacilli (2.2%) were detected in 23 samples (2.6%), and the associated locations were mainly distributed in train compartments during evening rush hours. Conclusion The total bacteria count in indoor air varies by monitoring sites of subway stations and time periods, and there is a risk of opportunistic bacterial infection. Attention should be paid to cleaning and disinfection during peak passenger flow hours in all areas.