Objective To study the clinical efficacy of cell block yielded by ultrasound-guided fine needle aspiration in the early diagnosis of thyroid cancer and differential diagnosis of thyroid follicular tumor.Methods Cytological smears were performed in 864 thyroid nodules by ultrasound-guided fine needle aspiration.Then the residual specimens were made as cell blocks.Diagnosis was made by observation of the organization structure of the cell block.Cell block sections from 78 nodules with diagnosis of follicular tumors were applied to the detection of immunocytochemical staining for minichromosome maintenance protein (MCM2), growth arrest and DNA damage-induced nuclear protein 153 (GADD153), and Ki-67.Results Satisfaction rate of cytological smear combined with cell block specimen was 94.3 ％ (815/864) and accuracy rate of the diagnosis was 94.0％ (766/815), which were higher than in cytological smear group (P＜0.01).The false negative rate of cytological smear combined with cell block specimen was 16.6％ (41/247)in diagnosis of thyroid cancer.Positive rate of M CM2 and GADD153 in thyroid follicular neoplasia were lower than that of follicular carcinoma (P ＜ 0.01).There was no significant difference between thyroid follicular neoplasia and follicular carcinoma in regard to positive rate of Ki-67 (P ＞ 0.05).Conclusions The combination of ultrasound-guided fine needle aspiration-yielded cell block and molecular markers has great significance in early diagnosis of thyroid cancer and differentially diagnosis of thyroid follicular tumor.

Objective To systematically evaluate the clinical effect and safety of repaglinide and metformin for treating diabetes mellitus (MD) of secondary failure of sulfonylurea (SFS).Methods The randomized controlled trials (RCT) at home and abroad on the comparison of effect and safety of repaglinide and metformin in treating MD with SFS were retrieved.The modified Jadad scale was employed to evaluate the literature quality.The RevMan5.3.1 software was used for conducting the meta analysis.Results A total of 10 RCT were included.The meta-analysis results showed that compared with metformin for treating MA with SFS,repaglinide decreased the fasting blood glucose effectively (MD=-2.30,95 ％ CI:-2.53--2.06,P＜0.01),increased the fasting C-peptide (MD=0.06,95％CI:0.02-0.11,P=0.01),reduced the postprandial 2 h blood glucose (MD=-2.17,95 ％CI:-2.44-1.89,P＜0.01) and decreased glycosylated hemoglobin (MD=-2.60,95％CI:-3.21--2.00,P＜0.01) as well as the adverse reactions (RR=0.05,95％CI:0.02-0.09,P＜0.01).However,there was no statistical difference in fasting insulin between the repaglinide and metformin groups (MD=0.18,95％CI:-0.18-0.54,P=0.32).Conclusion Currently evidences suggest that repaglinide is superior to metformin for treating MD with SFS.

Objective:To analyze the influence of epidural labor analgesia on neonatal breast-seeking behavior and first breastfeeding.Methods:This study was an observational study. According to the cross-sectional study formula and inclusion and exclusion criteria, 150 cases of puerperas and their full-term infants who underwent vaginal delivery in the Affiliated Hospital of Southwest Medical University from March to September 2020 were included as the research objects, and the time of breast searching behavior in newborn crawling was observed and recorded. According to whether epidural analgesia was used or not, the patients were divided into analgesic group and non-analgesic group (the specific names of the two groups), and the outcome variables were analyzed.Results:There were 81 cases of successful breast crawl, 69 cases of failure, including 94 cases of epidural analgesia, 56 cases of non-epidural analgesia. Epidural analgesia had no effect on breast crawl and the time of breast searching behavior ( P>0.05). For puerperas with epidural analgesia, the total score of Breastfeeding Assessment Tool (IBFAT) and the scores of its four dimensions such as feeding time, foraging, sucking and nipple holding behavior were 9(7, 10), 3(2, 3), 2(2, 3), 2(1, 2), 2(1, 2), which lower than those non-epidural analgesia puerperas, which were 10(8, 10), 3(3, 3), 3(2, 3), 2(2, 2), 2(1, 2), the differences were statistically significant ( Z values were -6.36- -4.32, all P<0.05). Conclusions:When epidural analgesia is used clinically, medical staff need to seize the best time of drug use, pay attention to continuous monitoring of drug use duration and dosage, while exerting drug analgesia effect, it is also necessary to minimize adverse outcomes and reduce the impact of analgesics on breastfeeding.

BackgroundPerinatal depression seriously affects the physical and mental health of pregnant women， such as affecting their role transition， identity， and family relationships， etc. In severe case， it can even lead to suicidal behavior， causing a heavy burden on pregnant women and their families. A hierarchical management model centered on pregnant women， involving collaboration of families， communities， and hospitals， facilitates comprehensive and dynamic management of perinatal depression. ObjectiveTo evaluate the application effect of "Internet +" hospital-community-family trinity linkage management model on perinatal depression in pregnant women， in order to provide a reference for the clinical intervention. Methods80 pregnant women who established medical records from the Department of Obstetrics and Gynecology of Mianyang Third People's Hospital from January to December 2022， with Edinburgh Postnatal Depression Scale （EPDS） score>9， were selected as the research objects. According to the random number table method， they were divided into a study group and a control group， each group consisting of 40 cases. Both groups received routine nursing intervention in the pregnant women's school of obstetrics and gynecology outpatient department before delivery， and in the study room of the department of obstetrics and gynecology after being admitted to the hospital for delivery. After discharge， they received routine follow-up until 42 days postpartum. The study group received the "Internet +" hospital-community-family ternary linkage management on the basis. EPDS， Pittsburgh Sleep Quality Index （PSQI）， Generic Quality of Life Inventory （GQOLI-74） and Nursing Satisfaction questionnaire were assessed before intervention and 42 days postpartum. ResultsAfter intervention， the EPDS score and PSQI score of the study group were lower than those of the control group （F=42.823， 60.453， P<0.05）， GQOLI-74 score and nursing satisfaction were higher than those of the control group （F=198.902， χ²=5.165， P<0.05） . Conclusion"Internet +" hospital-community-family trinity linkage management model may help to improve the severity of perinatal depression symptoms， improve the quality of sleep and life， and increase the satisfaction of pregnant women.［Funded by Mianyang Health Scientific Research Commission Project （number， 202134）］