This article introduced TCM master Zhang Zhen's experience of using theory of"one body with two wings,regulating qi movement"in the treatment of thyroid nodules.The onset of thyroid nodules is due to liver depression and qi stagnation,and the booster of the onset is spleen and kidney dysfunction.The main pathogenesis is liver depression and qi stagnation,spleen deficiency and phlegm coagulation,kidney deficiency and blood stasis.The disease is located in the liver,spleen,and kidney.The general principle for treating thyroid nodules is to regulate the liver to regulate"the body",while the key points for treating thyroid nodules are to supplement the spleen and kidneys to supplement"the two wings".The combination of promoting blood circulation and dispersing nodules is the target for treating thyroid nodules.The clinical treatment of thyroid nodules with Shutiao Xiaohe Decoction has a significant therapeutic effect.

[Objective] To analyze the influence of the cycle length of hepatitis B surface antigen (HBsAg) double reagent positive samples collected from voluntary blood donors in Guangzhou on the detection results. [Methods] A total of 127 044 blood samples from voluntary blood donors at Guangzhou Blood Center from August 10 to December 9, 2023 were selected. Two ELISA reagents were used for HBsAg detection, and samples with HBsAg double reagent positive and S/CO values<10 were tested continuously for 7 days to observe the changes in their S/CO values. [Results] A total of 505 HBsAg double reagent positive samples were detected, of which 52 had S/CO values less than 10. After 7 consecutive days of uninterrupted testing, the S/CO values of Wantai (median 5 decreased to 3) and Xinchuang (median 5 decreased to 3) showed an overall downward trend, and the HBsAg missed detection rate showed an upward trend (from 0 on the first day to 1/10 000 on the seventh day). A total of 13 cases had negative double reagent test results within the 7-day testing cycle. [Conclusion] With the extension of the detection cycle, the S/CO value of HBsAg detection shows a downward trend, and the missed detection rate of HBsAg shows an upward trend. Samples used for HBsAg detection should be tested promptly after sampling to improve the quality of blood testing.

Objective:To observe the efficacy of drug combined with red-blue light irradiation, chemical peeling by glycolic acid and intense pulsed light (IPL) in the treatment of moderate acne vulgaris.Methods:A total of 187 patients with moderate acne vulgaris were divided into five groups. There were 59 males and 128 females, aged from 16 to 29 years (21.79±2.52). In group A, patients were treated with oral medicines; the patients were treated with oral medicines combined with red-blue light irradiation, chemical peeling by glycolic acid and IPL respectively in group B, group C and group D. In group E, patients were treated with oral medicines combined with chemical peeling by glycolic acid and IPL. The number of different types of skin lesions (comedoes, papules, pustules) were compared between before and after treatment in five groups. The clinical effect of five treatment groups was evaluated by comparing regression rates of different types of skin lesions and total skin lesions and treatment efficiency.Results:All the patients with moderate acne vulgaris were brought into this study. The regression rates of comedoes, papules and total skin lesions were (86.37±9.64)%, (94.25±9.79)% and (88.80±9.40)% respectively in group E, and significantly higher than that of other four groups ( P<0.05). The treatment efficiency of group E also were significantly higher than that of other four groups ( P<0.05). Then, the regression rates of comedoes (70.91±18.52) in group C was significantly higher than that of group A and group B ( P<0.05). The regression rates of papules (91.42±13.86) in group D was significantly higher than that of group A and group B ( P<0.05). Conclusions:Oral medicines combined with chemical peeling by glycolic acid and IPL has obvious clinical efficacy in treatment of patients with moderate acne vulgaris. Oral medicines combined with chemical peeling by glycolic acid can obviously improve comedoes, and oral medicines combined with IPL can obviously improve papules.

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

OBJECTIVE: To develop a radioactive sewage purification device that can effectively filter the nuclides in low-level nuclide-contaminated wastewater. METHODS: The radioactive sewage purification device was composed of lifting pump, stack filter, multi-medium filter, security filter, tubular ultrafiltration membrane, high-pressure pump and reverse osmotic membrane. The combined process of adsorption-ultrafiltration-reverse osmosis was used to separate radioactive elements from wastewater by reverse osmosis membrane separation system. Through two-stage multi-medium filter circulation system circulation treatment, radioactive sewage was purified. The flow rate of water treatment is 20 L/min. The filtration efficiency and purification efficiency of the device were tested by filtration experiments on elements containing radionuclide and purification experiments on radionuclide.RESULTS: The filtration efficiency on iodine, potassium, strontium and cesium, that are the common elements in radioactive sewage samples were 97.88%, 98.38%, 99.99% and 99.80%, respectively. The single purification efficiency of radionuclide ~(40)K in low-level radioactive sewage was over 90.00%. CONCLUSION: The device has high filtering efficiency for common elements such as iodine, potassium, strontium and cesium in sewage and high removal rate of radioactive activity for sewage containing ~(40)K. It can be further optimized and transformed into a suitable radioactive sewage water purifier.

Objective To analyze the characteristics and treatment of aortic intramural hematoma ( IMH) in non-traumat-ic elderly patients, and to provide clinical reference for the diagnosis and treatment of this disease .Methods A retrospective analysis of clinical data of 36 elderly patients without trauma during the period from March 2013 to May 2017 in our hospital , to clarify the characteristics of pathogenesis and imaging feature , and to evaluate treatment options.Results 36 patients were followed up and the outcomes of them were satisfactory .Of which 17 asymptomatic patients were given conservative treatment . 19 cases of emergency patients, 7 patients received the emergency operation, 9 patients were given interventional treatment after initial conservative medical treatment, 3 patients received drug treatment, of which 1 patient was conservatively successful, and 2 patients progressed.During follow-up, the imaging data of most of the patients were obtained.The aortic enhanced CT indi-cated that the hematoma disappeared or decreased markedly, and the asymptomatic patients were in stable condition, and the dilatation of aorta was not obvious in patients who have access to imaging examination .Conclusion Elderly patients with IMH are more common in men, especially Stanford B type.IMH in asymptomatic elderly patients with multiple penetrating aortic ul-cer(PAU), but the range of hematoma is limited, no significant progress.And this type of patients can be considered only for conservative treatment.On the contrary, IMH of symptomatic elderly patients usually involve a wide range of aorta , and most of them were caused by single small ulcer.Although the patients have been treated with conservative medicine , the disease is still progress and endovascular treatment repair of aorta can be considered .

Objective To analyze the specimen types,ward distribution and risk factors for infections caused by extended-spectrum β-lactamase(ESBLs)-producing-Escherichia coli(ECO) in recent two years,so as to provide bacteriological basis for both hospital infection control and clinical anti-infection treatment.Methods Non-repetitive 443 ECO strains isolated from the hospitalized patients in the Third People′s Hospital of Shenzhen were collcted,and the phoenix100 system was employed for bacterial identification and antimicrobial susceptibility tests.ESBLs-ECO was further confirmed by the double-disk synergy test,and the risk factors caused ESBLs-ECO were statistically analyzed.Results A total of 115 strains of ESBLs-ECO were identified among the 443 strains of ECO,which accounted for 26.0%.The ESBLs-ECO strains were mainly isolated from the sputum,urine,and blood specimens.Among the isolated ESBLs-ECO strains,20.9% were isolated from the department of Tuberculosis,13.9% from the department of pediatric,12.2% from the department of live disease,and 8.7% from the department of infection.The male sex,surgery and use of the third generation cephalosporins were independent risk factors of ESBLs-ECO infection.Conclusion The isolation rate of ESBLs-ECO in this hospital is high.It is necessary for the hospital to strengthen the control of nosocomial infections according to the risk factors.More attention should be payed on male patients,the standardization of surgical operation and disinfection,and the restriction of using the third generation cephalosporins,so as to reduce the incidene of ESBLs-ECO infections.

Objective To discuss the perioperative nursing measures and their effectiveness for patients with malignant airway stenosis who are receiving airway stent implantation once more due to airway re-stenosis.Methods The clinical data of 7 patients,who received airway stent implantation once more due to airway re-stenosis during the period from May 2014 to July 2016,were retrospectively analyzed.The effectiveness of nursing intervention for stent implantation was assessed.Results The symptoms of dyspnea were relieved immediately after the stent re-placement procedure in all the 7 patients,and no severe complications,such as massive hemorrhage,respiratory failure or asphyxia occurred.Conclusion The key points to ensure a successful second airway stent implantation include following measures and preparations:cooperation mode of medical care integration,preoperative individualized psychological intervention,guiding the patients to cooperate with the treatment,ready for in-operation emergency rescue,rapid and effective assistant cooperation for stent placement,and postoperative close observation for the occurrence of respiratory tract infection,bleeding and other complications.

Objective To determine the influencing factors of post-stroke depression by machine learning.Methods Stroke patients' medical records (688 cases eligible) were extracted from record system,including age,gender,pulse manifestation,complexion,tongue quality,fur,Chinese medicine intervention,body mass index (BMI),blood pressure,blood glucose,blood triglyceride,blood total cholesterol,smoking history,drinking history,depression family history,stroke lesion site in imaging,as well as the final depression judgment.Single rule algorithm (1R) was adopted to learn.The risk factors influencing post-stroke patients' depression in extracted information were determined.Then the cases collected were divided into the training dataset (500 cases) and the test dataset (188cases).Optimal discriminant results were obtained by random forest model.Results Single rule algorithm showed that the most important influencing factor of post-stroke depression was stroke lesion site.By computer speculation,stroke lesions in the frontal and temporal lobes were most prone to post-stroke depression.Basal ganglia,brain stem,cerebellum,medulla oblongata and occipital lobe lesions were less likely to cause depression.The accurate classification rate could amount to 88.95％ (612/688 cases).Random forest model determination was made in the former 500cases in the training dataset.The total correct rate of determining depression was 98.2％.The total correct rate of determination in 188 cases of the test dataset was 99.47％.Six hundred and eighty-eight patients' data were learnt by random forest model.The total correct rate was 98.84％.The importance measure results showed that top 3 important indexes of post-stroke depression were lesion site,Chinese medicine intervention and depression family history.Conclusion Patients with lesions in the frontal & temporal lobes and depression family history were most prone to post-stroke depression.

Objective To discuss the clinical application value of Omaha system-based targeting nursing care for patients with hepatocellular carcinoma (HCC) who were treated with transcatheter arterial chemoembolization (TACE).Methods A total of 60 advanced HCC patients,who were planned to receive TACE,were prospectively and randomly divided into the control group (n=30) and the observation group (n=30).Routine nursing mode was adopted for the patients in the control group,while Omaha system nursing model was employed for the patients in the observation group.The patients of the observation group were evaluated with Omaha system at the time of admission,the key common problems were screened out and targeted nursing measures were employed.Meanwhile,on the days of admission and discharge all the patients of both groups were asked to fill in the forms of Hamilton depression scale (HAMD-17),Hamilton anxiety scale (HAMA),social support rating scale (SSQ) and numerical pain rating scale (NRS);and the degrees of depression,anxiety,social support and pain were respectively assessed.Results Both nursing modes could improve the degrees of depression and anxiety as well as the social support system of HCC patients,but the curative effect of these two aspects in the observation group were obviously better than those in the control group (P＜0.05).No statistically significant difference in the improvement of pain degree existed between the two nursing models,but Omaha system-based targeting nursing mode could alleviate the patient's pain to a certain extent.Conclusion For patients with advanced HCC,Omaha system-based targeting nursing care can alleviate the patient's negative emotion and promote the patients to establish effective social support system,this nursing mode is superior to conventional nursing mode.Therefore,Omaha system-based targeting nursing has great application potential in clinical practice.