OBJECTIVE To evaluate the short-term efficacy of single-session microwave ablation for benign thyroid nodule.METHODS Patients with benign thyroid nodules treated by microwave ablation between June 2019 and December 2022 at the Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,were included for analysis.Thyroid function was tested 1 month after treatment,and ultrasound and thyroid function were performed 3 months,6 months and 1 year after treatment.Volume reduction rates(VRR)of nodules were calculated.Data of the last follow-up within 1 year were included for analysis.Variables including gender,age,whether Hashimoto's thyroiditis was present,longitudinal diameter of nodules,solid volume of nodules were included for univariate and multivariate analysis.RESULTS A total of 151 patients with 163 nodules were included.The perioperative complication rate was 1.99%(3/151).The VRR at half year after treatment was(79.58±17.70)%,and the success rate at half year after treatment was 93.43%(128/137).The VRR of at 1year after treatment was(81.24±24.29)%.The 1-year treatment success rate was 92.77%(77/83).Univariate and multivariate analysis showed that nodular solid volume and age were independent factors affecting VRR after ablation.Regression coefficient of age and solid volume was 0.34(P<0.05)and-0.47(P<0.05),respectively.For every 1 cm3 increase in solid volume,1-year VRR(%)decreased by 0.47.Regression equation:1-year VRR=68.92+0.34×age-0.47×solid volume.Serum FT4 gradually decreased and the thyroid stimulating hormone(TSH)gradually increased within 6 months after ablation,and the differences were statistically significant(P<0.05).After 6 months,serum FT4 gradually recovered to the normal level and TSH gradually recovered.However,TSH still did not reach the preoperative level one year after ablation.FT3 decreased gradually after treatment,but there was no significant difference between the values at each time point(P=0.40).After the ablation of thyroid nodule,the mean value of thyroid function index fluctuated,but all of them were within the normal reference range.CONCLUSION Microwave ablation is a safe and effective treatment method for benign thyroid nodules,with an overall success rate of over 90%.Solid nodule volume and age are independent factors affecting the microwave ablation effect of benign thyroid nodules.

Objective:To explore the effect of pectin on improving intestinal barrier injury in elderly stroke patients.Methods:A total of 60 elderly stroke patients who received enteral nutrition in Department of Critical Care Medicine of Taizhou People's Hospital from November 2020 to October 2021 were included. The control group included 30 cases, using conventional enteral nutrition solution. The other 30 cases were in the study group, and pectin was added on the basis of routine enteral nutrition solution. The levels of serum diamine oxidase (DAO) and D-lactic acid (D-LA) were measured on the first and 7th days of enteral nutrition to evaluate the intestinal barrier function of elderly stroke patients. The levels of interleukin-6 (IL-6), procalcitonin (PCT) and high-sensitivity C-reactive protein (CRP) were measured to evaluate the inflammatory response level of elderly stroke patients. The clinical prognosis of the two groups was compared.Results:Compared with the control group, the values of DAO [(4.05±1.56)ng/mL] and D-LA [(6.11±2.20) μmol/L] in the study group were significantly lower than those in the control group on the 7th day (all P < 0.05). Also the levels of IL-6 [(15.43±12.53) ng/mL], PCT [(0.82±0.98) ng/mL] and CRP [(6.94±6.60) mg/L] in the study group were lower than those in the control group, and the difference between the two groups was statistically significant (all P < 0.05). Compared with the control group, the length of ICU stay and total length of hospital stay in the study group were shorter than those in the control group ( P<0.05), but there was no significant difference in the incidence of stroke-related pneumonia (16.7% vs. 30.0%) and 30-day mortality (16.7% vs. 20.0%) between the two groups ( P>0.05). Conclusions:The enteral nutrition with pectin supplementation can improve intestinal barrier function and reduce inflammatory response in elderly stroke patients.

Purpose: This study explored the effect of a nursing comprehensive skill training course (NCST-C) on the metacognitive awareness of nursing students to provide a scientific foundation for improving metacognitive awareness. Methods: This study used a quasi-experimental two-group matched pretest, post-test, and follow-up test. Ninety-six junior nursing students were recruited using convenience sampling and assigned to two groups by drawing lots with odd and even numbers in a nursing school at Huzhou University. The control group received a traditional skill-training course. The intervention group received NCST-C.Nursing students' metacognitive awareness inventory (MAI) was evaluated at the baseline, 16-week, and 20-week follow-up points. A repeated-measures analysis of variance and a simple effect test was used to compare each outcome measure of the two groups three times. Results: The NCST-C resulted in greater benefits for nursing students' metacognitive awareness as well as various dimensions (knowledge of cognition and regulation of cognition) in the intervention group.Combined with a simple effects test, the MAI and dimension scores of those in the intervention group significantly improved at 16 weeks after the baseline (F ¼ 9.78e44.03; all ps < .01). The sustainable effect of NCST-C lasted 1 month after the intervention (F ¼ 14.24e62.36; ps < .01), reaching statistical significance (p < .05). Conclusions The NCST-C effectively developed metacognitive awareness among nursing students. Its design provides a new type of experimental course for improving metacognitive awareness.Trial registration: chictr.org.cn: ChiCTR2200057910. First registration date: 1/11/2020.

Objective:To explore the risk factors of acute kidney injury (AKI) in acute respiratory distress syndrome (ARDS) patients with mechanical ventilation.Methods:A retrospective analysis was conducted. ARDS patients with mechanical ventilation admitted to ICU of Taizhou People's Hospital from January 2019 to December 2019 were enrolled. Patients were divided into the AKI group and non-AKI group according to whether the patients had AKI. Clinical characteristics and laboratory indicators of the two groups were compared. Risk factors of incidence of AKI in ARDS patients were analyzed. The Kaplan-Meier survival curve was drawn to evaluate the survival rates of the two groups.Results:A total of 120 ARDS patients with mechanical ventilation were included, and 57 patients (47.5%) developed AKI. Procalcitonin, increased basal creatinine, decreased pH and impaired consciousness were independent risk factors for AKI in ARDS patients with mechanical ventilation. Fifty-seven of the 120 patients died with a mortality of 38.3%. The Kaplan-Meier survival curve showed that the survival rate of the AKI group was significantly lower than that of the non-AKI group ( P<0.001). Conclusions:The incidence and mortality of AKI is high in ARDS patients with mechanical ventilation. Procalcitonin, increased basal creatinine, decreased pH and impaired consciousness are independent risk factors for AKI in ARDS patients with mechanical ventilation.

Objective:To explore the feasibility of quantitative evaluation of extracellular volume (ECV) fraction in acute ST-segment elevation myocardial infarction (STEMI) by dual-layer spectral detector CT.Methods:The clinical and imaging data of 20 patients with STEMI who underwent cardiac contrast-enhanced CT and MRI from January to October 2019 in Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed.The dual spectral detector was used in the enhanced CT scan of the coronary artery with retrospectively gate and the late iodine enhancement with prospective gate. Conventional image and holographic spectral image were obtained by iterative and spectral reconstruction. The short axis image of the heart matched with MR image was obtained by multiplanar reconstruction. Based on the data of spectral based image, the IDD map was reconstructed for the calculation of myocardial CT-ECV during the late iodine enhancement. ECV of infarcted myocardium, salvageable myocardium and remote myocardium based on CT and MRI were calculated respectively. Bland-Altman consistency test and intra group correlation coefficient analysis (ICC) were used to compare the consistency of two measurements and different methods. The correlation between CT-ECV and MRI-ECV was compared by Spearman method.Results:The CT-ECV values of infarcted, salvageable, and remote myocardium were 51.21 (49.27, 53)%, 38.64 (36.17, 40)%, and 51.21 (49.27, 53)%, respectively. The difference was statistically significant ( H= 43.17, P<0.01). The CT-ECV value of infarcted myocardium was significantly higher than that of salvageable myocardium and remote myocardium ( Z=-24.60, 35.40, P<0.01), but there was no significant difference between salvageable myocardium and remote myocardium ( Z= 10.80, P=0.15). The T 1 values of infarcted myocardium, salvageable myocardium and remote myocardium were (1 554.85±70.94), (1 443.85±67.28) and (1 307.05±91.73) ms respectively, the difference was statistically significant ( F=51.35, P<0.01). The T 1 value of infarcted myocardium was higher than that of salvageable myocardium and remote myocardium ( t=-5.07, 9.55, P<0.01), and salvageable myocardium was significantly higher than that of remote myocardium ( t=5.38, P<0.01). The MRI-ECV values of infarcted myocardium, salvageable myocardium and remote myocardium were 55.00 (49.27, 57.75)%, 33.50 (29.00, 35.00)%,and 27.00 (26.00, 29.00)%, respectively. The difference was statistically significant ( Z= 47.12, P<0.01). MRI-ECV of infarcted myocardium was significantly higher than that of salvageable myocardium and remote myocardium ( Z=37.45, -20.30, P< 0.01), and salvageable myocardium was significantly higher than that of remote myocardium ( Z = 17.15, P<0.05). The difference between CT-ECV and MRI-ECV measured by two physicians was good. The bias of Bland-Altman analysis was -0.1% (95% CI:-5.5%-5.2%), 0.8% (95% CI:-9.8%-8.2%), and the ICC values were 0.92 and 0.94, respectively. The bias of Bland-Altman analysis in CT-ECV and MRI-ECV consistency test was 4.00% (95% CI:-9.0%-16.9%) and ICC value was 0.88, which had a good correlation ( r=0.75, P=0.001). Conclusions:The iodine density based ECV fromdual-layer spectral detector CT can be used to quantitatively evaluate the changes of extracellular space after acute STEMI, which is helpful to quantitatively evaluate the histological changes after myocardial ischemia.

Objective: To analyze the CT manifestations of the 2019 novel coronavirus pneumonia (NCP) combined with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) literature review, and to summarize the characteristics of CT imaging, so as to improve the ability of rapid and accurate diagnosis. Methods: CT manifestations of two confirmed cases of NCP were reported, meanwhile the literatures on SARS and MERS imaging performance were reviewed and summarized. Results: The two cases of NCP were both in acute stage, the CT imaging showed multiple and scattered ground-glass opacity (GGO) in both lungs, which is similar to the CT performance of SARS and MERS in acute stage. Conclusions The CT features of 2019 novel coronavirus pneumonia are similar to SARS and MERS. It has certain characteristics and changes rapidly with the course of the disease. In the acute stage, GGO and paving stone sign were the main manifestations. In the acute phase, GGO and crazy paving are the main manifestations. In the progress stage, the interlobular septal thickening and consolidation appeared. During the absorption period, the lesions disappeared or fibrosis was left behind, with lung structure distortion and bronchiectasis. Lymphadenopathy and hydrothorax were rare.

Objective To adopt the meta analysis to evaluate the living quality of empty-nest elderly based on Pearson and Spearson correlation coefficients.Methods The databases including Cochmne library,PubMed,PIDQuest,Medline,Springerlink,CMB,CNKI,VIP and WanFang Data were retrieved by using the network databases with the retrieval time limit until July 2016.The literatures on the correlation between the social support and living quality of Chinese empty-nest elderly were searched.The included studies were screened according to the inclusion and exclusion criteria.After extracting data and appraising the quality of the included studies,the meta analysis was conducted by using STATA11.0 software.Results Five articles were included.The literature quality was good as a whole.The total sample amounts were 2 485 subjects,including 1 201 males and 1 284 females.The meta analysis showed that merge correlation coefficient of social support and living quality,and 95 ％ confidence interval(CI)were 0.287 (0.252,0.329);which of social support utilization degree and living quality were 0.232 (0.191,0.274);which of subjective support and living quality were 0.260 (0.224,0.298),which of objective support and living quality were 0.139 (0.101,0.179),after merge,the correlation coefficient of social support was highest.The living quality and social support total score were increased with the samples amounts increase,and the correlation was accordingly decreased.The correlation coefficient measured by random sample method was higher than that measured by the non-random sample method.The correlation coefficient and social support in southern empty-nest elderly was higher than that of northern empty-nest elderly.Conclusion The living quality in Chinese empty-nest elderly has a correlation with the social support,which is mainly affected by subjective support and support utilization degree.

OBJECTIVE: To investigate influence of setting time on bond strength of different bioactive pulp capping materials with self-etch or etch-and-rinse adhesive. METHODS: Sixty specimens were prepared for each of the three tested capping materials, namely mineral trioxide aggregate (MTA), iRoot BP Plus (BP) and iRoot FS (FS). Specimens of each material were divided into three groups and bonded at three setting time points of the materials respectively: initial setting time (4 h for MTA, 2 h for BP and 20 min for FS), 24 h after application and 7 d after application. The specimen surfaces of each group were treated with self-etch mode or etch-and-rinse mode of one universal adhesive (Single Bond Universal, SBU) (n=10). The bonding area was restricted to a round area with 3 mm diameter, on which composite cylinders were build up with flowable composite and light cured completely. The shear bond strength was tested immediately with a shear strength tester and fracture mode was observed under stereo microscope and recorded. The mean shear bond strength for each group was analyzed with SPSS 19.0 software ANOVA method. The surface morphology of each material was observed after setting and acid treatment under scanning electron microscope. RESULTS: There was no significant difference among the three tested materials at either initial setting point or 7 d after application (P<0.05). The bond strength of MTA was significantly higher than those of BP and FS 24 h after application in both bonding modes (P<0.05). For all the three tested materials, shear bond strength was significantly higher for complete setting group than for initial setting group of the same material (P<0.05). Under scanning electron microscope, the characteristic crystal patterns could be observed on the three bioactive materials surfaces after complete setting, the size of which was bigger for MTA than for BP and FS. These features were lost to some extent after self-etch primer application or phosphoric acid etching. CONCLUSION Based on the present results, adequate bond strength can be obtained for FS at initial setting time, which is comparable with BP and MTA. This implies that clinically composite restoration can be placed over bioactive direct capping materials after shortened initial setting process in one visit.
Acid Etching, Dental ; Composite Resins ; Dental Bonding ; Dental Cements ; Dental Materials ; Dental Pulp Capping ; Dental Stress Analysis ; Dentin-Bonding Agents ; Materials Testing ; Resin Cements ; Shear Strength

Objective To explore the relationship between health-related media information and career decision making self-efficacy of nursing undergraduates,and the mediation effect of psychological needs and trust between above two variables. Methods Totally 548 nursing undergraduates were investigated using basic properties of health-related media information questionnaire,health-related media information of trust and psychological needs questionnaire and Career Decision Making Self-efficacy Scale. Results Health-related media information and health-related media information of trust and psychological needs could predict mental disability directly (P<0.05). Health-related media information of trust and psychological needs played a mediating role between health-related media information and career decision making self- efficacy,and the total effect and the indirect effect of two separate intermediary variables were significant,and contribution rate of 50.31%. By confirmatory factor analysis, structural equation model were:χ2/degree of freedom (χ2/df)=4.225, goodness of fit index=0.933, adjusted goodness of fit index =0.902, root mean square error of approximation =0.070. Conclusions Nursing school administrators should pay close attention to the mediating roles of health-related media information of trust and psychological needs,and develop specific interventions systematic on the basis of a comprehensive assessment,so as to improve nursing students career decision-making self-efficacy levels.

Objective To prepare novel alkanethiol modified magnetic silver flower nanoparticles as SERS substrate to chloramphenicol for Raman detection and to determine their enhancement effect.Methods An alkanethiol was chosen as a surface modifier of the substrate and was self-assembled onto the magnetic silver flower nanoparticle surface.The chloram-phenicol molecules were enriched to the surface of the substrate by hydrophobic interaction and the effect for detection of chloramphenicol SERS signal was enhanced.Results It was found that the 1-hexanethiol-modified SERS substrate was able to lead to stronger enhancement than 1-dodecanethiol and octadecanethiol.Fe3 O4@SiO2-Ag-C6 was used to detect the chloramphenicol (10 -3 -10 -10 mol/L) and chloramphenicol in milk (10 -3 -10 -9 mol/L) by surface-enhanced Raman spectroscopy.The detection limits were 0.1 nmol/L (32 ppt) and 1 nmol/L (323 ppt) respectively.Conclusion Alkanethiol modified magnetic silver flower nanoparticles are a highly active SERS substrate, which can be used for detection of low concentrations of analytical substances.