Objective To compare the clinical efficacy and safety of ultrasound-guided microwave ablation(MWA)combined with percutaneous ethanol injection(PEI)and MWA alone for the treatment of cystic-solid thyroid nodules.Methods A computerized retrieval of academic papers concerning the randomized controlled trials(RCT)on the comparison of the effectiveness and safety between MWA combined with PEI(combination group)and MWA alone(simple MWA group)for cystic-solid thyroid nodules from the databases of PubMed,China National Knowledge Internet(CNKI),Wanfang Database,etc.was conducted.The quality of the enrolled articles was assessed according to the Newcastle-Ottawa scale(NOS)score.Results A total of six articles including 458 patients were finally included in this meta-analysis.Meta-analysis showed that the volume reduction rate of cystic-solid thyroid nodules in the combination group was higher than that of the simple MWA group(P＜0.05).No statistically significant differences in the complication incidences of hoarseness and fever existed between the two groups(both P＞0.05),but the complication incidences of bleeding and neck pain in the combination group were lower than those in the simple MWA group(both P＜0.05).Conclusion In treating cystic-solid thyroid nodules,MWA combined with PEI is superior to MWA alone in the curative effect and clinical safety.

ObjectiveTo analyze drug resistance status and risk factors in elderly tuberculosis patients in Ninghai County of Zhejiang Province， and to provide basis for prevention and control of drug-resistant tuberculosis. MethodsClinical data were collected from 142 elderly tuberculosis patients （with positive sputum culture） who were diagnosed and treated in medical institutions in Ninghai from 2016 to 2020. The risk factors of drug resistance were analyzed by Chi-square test and logistic regression model. ResultsThe overall drug resistance rate was 33.80%， and the drug resistance rate in patients with recurrent pulmonary tuberculosis was significantly higher than that in patients with initial pulmonary tuberculosis， and the difference was statistically significant. Multivariate unconditional logisitic regression analysis showed that irregular medication and disease recurrence were independent risk factors for multidrug resistance in the elderly patients. ConclusionThe drug resistance rate in elderly tuberculosis patients in Ninghai is high. It is necessary to strengthen the management and supervision of tuberculosis in the community， and to carry out effective health education and visit for elderly patients， especially for newly treated patients， and to avoid treatment failure caused by irregular medication and interruption of treatment.

Objective To discuss the treatment method and opportunity for patients with gallbladder stones and extrahepatic bile duct stones who failed endoscopic removal of common bile duct stones by endoscopic retrograde cholangiopancreaticography (ERCP). Methods 12 patients, with gallbladder stones and extrahepatic bile duct stones, failed endoscopic stone extraction (ESE), underwent emergency one-stage laparoscopic cholecystectomy (LC) and Laparoscopic common bile duct exploration (LCBDE). Results All of the patients were successfully completed LC +LCBDE and stones were completely removed. Hyperamylasemia occurred in 3 cases and there was no bile leakage, intestinal leakage, cholangitis, pancreatitis, biliary bleeding and other complications. Conclusions Emergency LCBDE has been shown to be a safe and effective salvage procedure for failed ESE.

Objective To investigate the clinical characteristics and treatments of early-stage acute pancreatitis following laparoscopic cholecystectomy (LC). Methods From April 1998 to June 2006,totally 18 470 cases of LC were performed in our hospital,16 (0.09%) of them developed early-stage acute pancreatitis (