Objective: Thyroid nodules are common clinical thyroid disorders.The purpose of this study was to investigate the diagnostic value of the clinical characteristics and various parameters of malignant thyroid nodules and the sensitive indexes for their differentiation so as to improve the diagnosis of malignant thyroid nodules and avoid unnecessary procedures or operations.Methods: We retrospectively studied 600 cases of thyroid nodules treated by surgery from 2001 to 2008,divided them into a benign and a malignant group according to the pathological results,and analyzed by multivariate logistic regression the correlation between the nature of thyroid nodules and various factors.Results: Of the 600 cases of thyroid nodules,519(83.47%) were benign and 81(16.53%) were malignant.Clinical symptoms and signs,ultrasonography and CT were all useful in indicating malignancy,especially ultrasonography,whose specificity and diagnostic accuracy were 93.3% and 84.2%,respectively.Multivariate logistic regression analysis revealed a higher rate of malignancy in younger patients with solid or hard nodules,or accompanied with calcification or painless adenophyma in the neck.Conclusion: Clinical symptoms and signs,ultrosonography and CT are of significant value in the diagnosis of malignant thyroid nodules.

Objective:To study the integrated information nursing mode of perioperative medical care under the multidisciplinary cooperation of hip fracture in the elderly patients, provide reference for perioperative nursing of elderly hip fracture.Methods:A total of 1 019 patients with hip fracture from May 2018 to May 2019 in Beijing Jishuitan Hospital were randomly selected as the study object, and the non synchronous control was used for the study. From May to December 2018, 527 elderly patients with hip fracture in orthopaedic department of general trauma were taken as the control group, adopting the traditional treatment and nursing mode; from January to May 2019, 492 elderly patients with hip fracture in elderly trauma orthopaedics department were taken as the intervention group. Under the multidisciplinary cooperation, the information-based nursing mode of integrated medical care was implemented, and a multidisciplinary integrated medical care team was established. The information-based platform was used to optimize the clinical nursing path, and standardized, individualized and continuous nursing scheme was developed. The time from visit to hospitalization, the time from hospitalization to operation, hospitalization time, incidence of more than moderate pain, incidence of venous thromboembolism, incidence of stress injury, incidence of delirium and satisfaction of patients and their families at discharge were compared between the two groups.Results:The number of patients in the intervention group was higher than that in the control group within 4 and 24 hours. The rate of operation in 48 h increased from 8.0%(42/527) to 50.0%(246/492), and the rate of operation in 1 week increased from 70.0%(369/527) to 99.0%(487/492). Compared with the control group, the incidence of more than moderate pain in the intervention group decreased from 85.0%(448/527) to 2.0%(10/492), the incidence of venous thromboembolism in the hospital decreased from 12.0%(63/527) to 4.1%(20/492), and the incidence of pressure injury in hip fracture in the elderly decreased from 2.1%(11/527) to 0.2%(1/492); the incidence of delirium in the hospital decreased from 21.1%(111/527) to 8.1%(40/492); the hospital stay was shortened from (13.42 ± 3.36) d to (7.26 ± 2.03) d, and the satisfaction of patients and their families increased from 60.9%(321/527) to 95.9%(472/492). There were statistical significance between the two groups (χ 2 values were 4.157-708.006, t value was -35.119, P<0.05 or 0.01). Conclusions:The information-based nursing mode of integrated medical care under the multidisciplinary cooperation can adapt to the development of hip fracture in the elderly, which is conducive to the accelerated rehabilitation of patients.

Objective:To investigate the clinical effect of linezolid combined with levofloxacin in the intensive treatment of tuberculous meningitis.Methods:Seventy-six patients with tuberculous meningitis who underwent intensive treatment from May 2015 to April 2018 in the Fourth People's Hospital of Taiyuan were included in this study. They were assigned to a control group ( n = 38) and an observation group ( n = 38) according to treatment methods. The control group was given conventional treatment (isoniazid + rifampicin + pyrazinamide + ethambutol). The observation group was given treatment with linezolid combined with levofloxacin based on conventional treatment. All patients were treated for 8 successive weeks. Clinical efficacy was compared between the two groups. Results:Total effective rate and the incidence of complications were 92.11% (35/38) and 5.26% (2/38) respectively in the observation group, and they were 68.42% (26/38) and 23.68% (9/38) respectively in the control group. There were significant differences in total effective rate and the incidence of complications between the two groups ( χ2 = 6.727 and 5.028, both P < 0.05). After treatment, white blood cell count, blood glucose level, and protein level were (30.21 ± 4.16) × 10 6/L, (3.65 ± 0.32) mmol/L and (0.79 ± 0.05) g/L, respectively in the observation group, while they were (54.28 ± 6.42) × 10 6/L, (2.18 ± 0.21) mmol/L, (0.98 ± 0.21) g/L, respectively in the control group. There were significant differences in white blood cell count, blood glucose level and protein level between the two groups ( t = 19.396, 23.675, 4.538, all P < 0.05). There was significant difference in the score of quality of life between the control and observation groups [(187.59 ± 4.11) points vs. (216.94 ± 3.90) points, t = 31.933, P < 0.05]. Conclusion:Linezolid combined with levofloxacin based on conventional treatment exhibits better clinical efficacy with high safety in the intensive treatment of tuberculous meningitis than conventional treatment.

Animals ; Humans ; Rats ; Respiratory Distress Syndrome, Adult ; etiology ; therapy

Reactive oxygen species (ROS) caused oxidative stress plays an important role in the occurrence and development of atherosclerosis,and it is associated with the occurrence of ischemic cerebrovaseular diseases.This article reviews the mechanism of action of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in atherosclerosis and ischemic cerebrovascular disease,and the neuroprotective effects of NADPH oxidase inhibitors.

Objective To investigate clinical value of serum procalcition(PCT) in early diagnosis of nosocomial infection in severe cerebral injury.Methods 58 patients with severe cerebral injury needing ICU monitoring were enrolled.Levels of serum PCT and C-reactive protein(CRP) and white blood cell(WBC) and nosocomial infection when entering ICU or on days 3 were observed.Results There were not difference in level Serum PCT when entering ICU in infection group compared with non-infection group(P ＞ 0.05).Serum PCT increeassd remarkably when entering ICU on days 3 in infection group as compared with non-infection group,the difference was significant (t =5.44,P ＜ 0.01).There were not difference in CRP and WBC level when entering ICU or on days 3 (all P ＞ 0.05).Conclusion Detection of serum PCT helps diagnosis early nosocomial infection in patients with severe cerebral injury.It is suggested that antibiotics should be chosen early in patients with obviously increased PCT,control abuse of antibiotics contributes to reduce incidence of drug resistance and mortality.

Objective To investigate the clinical characteristics of imflamatroy bowel disease (IBD) and the risk factors in developing eoloreetal cancers. Methods Five hundred and thirteen patients with IBD were consecutive collected from Jan. 1996 to Oct. 2007. The history database of these patients was established. The items including demography features, morbidity, diagnosis, the related risk factors, the treatment and outcomes were analyzed. Results Two hundred and forty two out of 513 patients were ulcerative colitis (UC). Of which 4 patients (1.65%) developed cancer and 4 (1.650%) were confirmed with precancer. But none of the 271 patients with Crohn's disease (CD) de-veloped cancer. The Logistic regression analysis showed that weight loss, complications and relapse might be the potential risk factors of the cancer. Conclusions In clinical, the probability that develope to cancer in patients with UC is higher than that in patients with CD. The main risk factors are frequent relapse, weight lost and complications.

Objective To investigate the correlation between the NADPH oxidase p22phox-A930G polymorphism and hypertensive intracerebral hemorrhage in Chinese Han population in Shanghai area.Methods The patients with hypertensive intracerebral hemorrhage and normal controls were enrolled.The polymerase chain reaction and the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to detect the genotypes and alleles of NADPH oxidase p22phox-A930G.Results A total of 128 patients with hypertensive intracerebral hemorrhage and 151 healthy controls were enrolled.The levels of systolic blood pressure,diastolic blood pressure,glucose,and triacylglycerol,as well as the proportions of smoking and alcohol consumption in patients of the hypertensive intracerebral hemorrhage group were significantly higher than those of the control group (all P＜ 0.05).There were significant differences in AA,AG,and GG genotypes (42.2％,44.5％,and 13.3％ vs.63.6％,27.8％,and 8.6％,x2 =12.757,P =0.002) and in A and G allele (64.5％ and 35.5％ vs.77.5％ and 22.5％ ;x2 =8.734,P=0.001) frequencies between the hypertensive intracerebral hemorrhage group and the control group.Multivariatelogistic regression analysis showed that systolic blood pressure ≥ 140 mm Hg (1 mm Hg =0.133 kPa) (odds ratio [OR] 13.952,95％ confidence interval [CI] 7.242-26.879; P ＜ 0.001),apolipoprotein A ≥ 0.99 mmol/L (OR 3.139,95％ CI 1.012-9.733; P =0.048),and AG +GG genotype (OR 2.333,95％ CI 1.253-4.342; P=0.008) were the independent risk factors for hypertensive intracerebral hemorrhage.Conclusions Among the Chinese Han population in Shanghai area,the NADPH oxidase p22phox-A930G polymorphism is an independent risk factor for hypertensive intracerebral hemorrhage.

A case of mandible plasma cell myeloma is reported.Plasma cell myeloma is a monoclonal neoplastic proliferation of plasma cells of bone-marrow derivation,usually multi-centric but jaw bones are rarely involved.The treatment requires precise pathological diagno-sis.The prognosis of solitary jaw bone lesions can be good after treatment.

The lipoprotein-associated phospholipase A2 (Lp-PLA2), a subtype of the phospholipase A2 superfamily, is produced primarily by macrophages and lymphocytes. Lp-PLA2specifically hydrolyzes oxidized phospholipids on oxidized low-density lipoprotein particles,resulting in production of lysophosphatidylcholine and oxidized fatty acids. Lp-PLA2 is expressed in atherosclerotic plaques and in macrophages within a fibrous cap of unstable plaque.Studies haw shown that the plasma Lp-PLA2 activity increases significantly in patients with ischemic stroke, and Lp-PLA2 may become an independent risk factor for predicting ischemic cerebrovascular events. The selective Lp-PLA2 inhibitor can reduce the inflammatory response,enhance the stability of plaques, and inhibit the formation of atherosclerotic plaques, and may become a new class of drugs for preventing the formation of atherosclerotic plaques.