Objective To explore the ultrasonic imaging features of malignant thyroid nodules risk fac-tors by logistic regression.Methods Two hundreds and forty patients with thyroid nodules by ultrasonic examina-tion and surgical treatment for patients with definited pathological diagnosis were included in this study.The pre-operative sonographic features of the nodules were put into the logistic regression model to explore the risk factors of ultrasonic imaging features of malignant thyroid nodules.Results By logistic regression model analysis,hypoe-cho,taller than wide≥1 and micro calcification were found to be significantly statistical variables for thyroid car-cinoma.Micro calcification could predict thyroid cancer for lymph node metastases.Conclusoin During clinical diagnosis,hypoecho,taller than wide more than 1 and micro calcification could be used as indicators by ultrasound doctors to judge malignant thyroid nodules and lymph node metastases.Prospective larger similar research is still very necessary to explore the indicator for thyroid carcinoma in the future.

Objective To establish the proposals of clinic and rehabilitation pathway for spine and spinal cord injury. Methods The experiences in clinic and rehabilitation treatment fields, the flow path of admission and the costs of hospitalization for spine and spinal cord injury patients in Chinese Rehabilitation Research Center were retrospectively summarized and analyzed. Related data in International Classification of Functioning, Disability and Health (ICF) core sets were also referred. Results The present proposals were applied to patients suffered from thoracic, lumbar or sacral spine injury with spinal cord injury. The proposals consisted of two parts: the surgical interventions in acute stage (within 2 weeks after injury) and clinic and rehabilitation treatments of spinal cord injury in sub acute and later stages (2 weeks to 6 months after injury). The criteria of surgical interventions in acute stage materialized the core therapies such as reconstruction of spine stability and neural decompression, etc. The criteria of treating spinal cord injury in subacute and later stages demonstrated the characteristic of combined therapy in which rehabilitation was the central element. Conclusion The establishment and implement of the present pathways were based on the time course of disease development and the staging feature of neural recovery and treatment after spinal cord injury. The purpose of this work is to improve the quality of medical service and reduce medical consumption.

Objective To evaluate the clinical diagnostic value of color Doppler ultrasound in diagnosis brucellosis with orchitis.Methods Hospital-based case-control study was used.We selected the patients with brucellosis orchitis who were hospitalized in Heilongjiang Land Reclamation Bureau General Hospital from 2014 to 2016 as a case group.At the same time,selected healthy people as the control group.Bilateral testicular size,parenchyma echo,flow signals in parenchyma,depth of bilateral testicular sheath membrane cavity effusion,testicular artery peak systolic velocity (PSV),end-diastolic velocity (EDV),pulsatility index,resistance index,peak systolic velocity/end-diastolic velocity,were measured and analyzed using color Doppler ultrasound.Results The case group included 62 patients;the health control group included 41 persons.The testicular volume of case group was compared to that of healthy control group,there was no statistical significant difference (cm3:15.81 ± 3.27 vs 15.82 ± 2.77,t =0.015,P ＞ 0.05).By analyzing the correlation between the course of the disease and the testicular volume,a negative relationship was found (r =-0.594,P ＜ 0.01).In the case group,the deep diameter of the testicular sheath was higher than that of the healthy control group,and the difference was statistically significant (cm:1.50 ± 0.53 vs 0.84 ± 0.21,t =10.777,P＜ 0.01).The PSV and EDV were higher than those in the control group (cn/s:(9.73 ± 3.25 vs 6.00 ± 1.38,2.89 ± 0.77 vs 2.46 ± 0.36,t =9.810,4.691,P ＜ 0.01).The pulsation index and resistance index were higher than that in the control group (1.06 ± 0.12 vs 0.82 ± 0.08,0.69 ± 0.05 vs 0.58 ± 0.04,t =15.678,12.763,P ＜ 0.01).Conclusions There are specific changes in Brucella patients with orchitis.The blood flow spectrum and testicular sheath membrane cavity effusion are specific changes.The color Doppler ultrasound can effectively evaluate Brucella orchitis patients with testicular injury,provide a reliable imaging basis for clinical treatment.

Objective:To observe the ratio of helper T cells 17 (Th17)/regulatory T cells (Treg) in peripheral blood of patients with Hashimoto's thyroiditis (HT) and the expression changes of related cytokines in serum, and to explore their role in the occurrence and development of HT.Methods:Using the case-control study method, 35 HT patients examined in the General Hospital of Heilongjiang Beidahuang Group from February to November 2019 were selected as HT group, and 39 healthy people in the same period were selected as control group. Early morning fasting venous blood samples of the two groups were collected to test the levels of thyroid stimulating hormone (TSH), free thyroxine (FT 4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). The expressions of serum interleukin (IL)-6, IL-17 and transforming growth factor β (TGF-β) were tested by enzyme-linked immunosorbent assay (ELISA); the number of Th17, Treg in peripheral blood were determined by flow cytometry. Results:The levels of TPOAb, TgAb and TSH in HT group [130.60 (43.37, 714.40), 368.10 (136.90, 1 103.00) U/ml, 9.05 (6.62, 15.23) μU/ml] were significantly higher than those in control group [2.66 (1.52, 4.69), 12.63 (11.43, 14.60) U/ml, 1.87 (1.36, 2.23) μU/ml, U = 6.87, 6.62, 4.85, P < 0.001], and the FT 4 level [0.76 (0.63, 1.04) ng/dl] was lower than that in control group [1.14 (1.02, 1.26) ng/dl, U = 7.39, P < 0.001]. The expressions of IL-6, IL-17 and TGF-β in HT group were higher than those in control group ( t = 2.41, 9.04, 2.44, P < 0.05). The number of Th17 and the ratio of Th17/Treg in HT group were higher than those in control group ( t = 4.20, 3.50, P < 0.05), and the number of Treg was lower than that in control group ( t = 4.45, P = 0.001). Conclusion:In HT patients, Th17 are increased, Treg decreased, Th17/Treg ratio increased, and the expressions of IL-6, IL-17 and TGF-β are increased.

Objective:To detect the changes in the levels of miR-21-5p and miR-125a-5p modified with 3′-terminal 2′-O-methylation (3′t-2′Ome) in serum extracellular vesicles (EV) of non-small cell lung cancer (NSCLC) patients, and evaluate their value as auxiliary screening molecular markers for NSCLC patients.Method:A retrospective analysis was conducted on the data of 69 NSCLC patients diagnosed at the Eastern Theater Command General Hospital from May 1st to October 31st,2023, as well as 65 age and gender matched healthy controls during the same period. Two real-time fluorescence quantitative PCR (RT-qPCR) techniques, namely stem-loop method and poly (A) tailed method, were used to detect the levels of 3′t-2′Ome-miR-21-5p and 3′t-2′-Ome miR-125a-5p in serum EV of NSCLC patients and controls.Analyze the correlation between the levels of two types of 3′t-2 ′Ome miRNAs and the differences in clinical stage, pathological classification, and other tumor indicators in patients. Receiver operating characteristic (receiveroperating curve, ROC) curves were used to analyze the efficacy of 3′t-2 ′Ome miR-21-5p and 3′t-2′ Ome miR-125a-5p in serum EV, as well as their combination, in diagnosing NSCLC.Result:Compared with the control group, the levels of 3′t-2′Ome-miR-21-5p in serum EV of NSCLC patients increased [(0.30±0.05) vs (0.35±0.09), t=3.32, P=0.001], while the levels of 3′t-2′Ome-miR-125a-5p decreased [(0.33±0.06 vs 0.25±0.06, t=7.45, P<0.001]. The differences were statistically significant. The expression levels of 2′Ome-miR-21-5p in EV were also significantly elevated in the NSCLC patients at 0-Ⅱ stage, adenocarcinoma patients, and squamous cell carcinoma patients, respectively. Notably, the levels of EV 3′t-2′Ome-miR-21-5p was also statistically significant between the adenocarcinoma patients and squamous cell carcinoma patients [(0.34±0.85) vs (0.40±0.12), P<0.05]. ROC curve analysis showed that the levels of 3′t-2 ′Ome miR-21-5p and 3′t-2′ Ome miR-125a-5p in serum EV, as well as their combined AUC for discriminating NSCLC patients, were 0.647(95% CI 0.550-0.743), 0.825(95% CI 0.756-0.894) and 0.860(95% CI 0.797-0.923), respectively. The sensitivity was 92.3%, 80.0%, 89.2%, and the specificity was 46.4%, 73.9%, and 78.3%, respectively. Conclusion:There are changes in the levels of 2 ′Ome miR-21-5p and 2′ Ome miR-125a-5p in the serum EV of NSCLC patients, and the combined detaction has the potential as an auxiliary screening molecular marker of NSCLC patients.

Children with certain comorbidities and immunocompromising conditions are highly vulnerable to SARS-CoV-2 infection. Vaccination against SARS-CoV-2 is an important strategy to reduce death， critical illness and overall disease burden. With the evolving and increasing transmission of SARS-CoV-2， universal vaccination is essential to achieve this goal. Children with special medical conditions are considered as the priorities for SARS-CoV-2 vaccination. However， vaccine hesitancy towards the implementation of SARS-CoV-2 vaccination currently remains an urgent challenge. In order to promote the sustainable vaccination for those children in Shanghai as well as China， Shanghai municipal center for disease control and prevention， together with the national children’s medical center， children’s hospital of Fudan university and the expert group on immunization planning of the Shanghai preventive medicine association， organized a consensus expert working group to formulate the evidence-based recommendations and implementation suggestions for children with common chronic diseases， allergy history， diseases involving adverse events related to vaccination， and immunocompromising conditions， based on the published evidence of SARS-CoV-2 vaccination for populations and children with special medical conditions.