Objective:To compare the short-term efficacy and the safety of microwave ablation (MWA) and radiofrequency ablation (RFA) in the treatment of benign thyroid nodules (BTNs).Methods:This prospective randomized controlled trial, performed from December 2019 to September 2021, included 36 patients with solid or predominantly solid BTNs who met the eligibility criteria and provided written informed consent at the Nanjing sub-center (Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine). Patients were assigned to either the MWA group or the RFA group (18 patients in each group) at a ratio of 1∶1 using a block randomization design and allocation concealment using sealed envelope randomization. The independent-sample t-test and χ2 test were used to compare the volume reduction rates (VRRs), effective rates (VRRs≥50%), cosmetic scores, and complication rates at 1, 3, and 6 months after treatment between the two groups. Results:The clinical characteristics of the two groups of patients were comparable. After ablation, the nodule volume was significantly reduced in both groups. At 1, 3, and 6 months, there was no significant difference in the volume between the two groups (all P>0.05). At 3 months, the RFA group had a larger VRRs than that in the MWA group (62.08%±12.46% vs. 46.90%±23.16%, t=-2.45, P=0.021). However, at 1 and 6 months, no statistical significance was observed (both P>0.05). No significant difference was observed in the effective rates at the last follow-up (14/18 vs. 18/18, P=0.104). However, the RFA group had a lower cosmetic score than that in the MWA group (1.78±0.43 vs. 2.17±0.51, t=-2.47, P=0.019). There was no statistically significant difference in the complication rates between the two groups (all P>0.05). Conclusions:Both MWA and RFA were effective and safe treatments for BTNs, with no significant differences in short-term efficacy and safety. In addition, the RFA group showed slightly more favorable outcomes than the MWA group in terms of cosmetic improvement.

Objective: The cross lagged analysis model is used to analyze the causal relationship between physical health education and adolescent health literacy, so as to provide empirical references for physical health education and adolescent health literacy improvement in China. Methods: Cluster sampling method was used to select 24 classes of grade 7 students from four junior high schools in Xiangyang City,Hubei Province,Dalian City,Liaoning Province and Liaoyuan City,Jilin Province.The longitudinal follow up design with an interval of 18 weeks was administered among 696 junior middle school students. The Revised School Physical Health Education Scale and Junior Middle School Students Health Literacy Scale were used. Results: T1 exercise supervision could significantly and positively predict T2 health literacy( β=0.18 ), T1 health literacy could also significantly and positively predict T2 exercise supervision( β=0.18)(P <0.01). T1 health education could significantly and positively predict T2 health literacy( β=0.57, P <0.01), T1 health literacy could not significantly and positively predict T2 health education( β=0.03, P >0.05). T1 physical education teaching could significantly and positively predict T2 health literacy( β =0.39), T1 health literacy could also positively and significantly predict T2 physical education teaching( β=0.10)(P <0.05). The three dimensions of physical health education had positive predictive effect on the three dimensions of health literacy( P <0.05). Conclusion In the process of physical health education, health education is the main factor affecting teenagers health literacy, with a vertical causal relationship between the two variables. There is a bi directional positive relationship between sports supervision, physical education teaching and adolescent health literacy.

Objective: The purpose of this paper is to systematically review the impact of physical activities on cognitive flexibility of children and adolescents in China, and to provide evidence based evidence for relevant research on improving cognitive flexibility of children and adolescents by using physical activities. Methods: CNKI, VIP, Wanfang Data, Web of Science, SPORTDiscus, PubMed, Springer link and Science Direct database were searched. The time span of 40 articles collected in this study was from the establishment of the database to December 31, 2020. Results: A total of 3 262 research samples were included in 40 articles, including 1 674 in the experimental group and 1 588 in the control group. Meta analysis showed that the total effect WMD value of literature was 121.11, Z =12.37, 95% CI =101.91-140.30 ( P <0.01); the sub group of school age children included 32 literatures, and the combined effect WMD value was 126.05, Z =10.42, 95% CI =102.34-149.76 ( P <0.01); the sub group of adolescents included 8 literatures, the combined effect WMD value was 104.00, Z =9.72, 95% CI =83.02-124.98 ( P <0.01). Compared with the control group, physical activity had a significant positive effect on the cognitive flexibility of Chinese children and adolescents. The source of heterogeneity in school age children group was tested by meta regression method. The results showed that the type of children t =12.77, 95% CI =28.79-39.74( P <0.01) was the primary source of heterogeneity in Meta analysis. The results of egger regression analysis showed that t =0.47, 95% CI =-1.48-2.37( P =0.64), and there was no publication bias. Conclusion Adolescence is the sensitive period for development of cognitive flexibility, and physical activities have a significant positive impact on the cognitive flexibility of children and adolescents.

Objective:To assess the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis of children with biliary atresia.Methods:A prospective survey of infants with hepatitis syndrome and hyperbi-lirubinemia in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to December 2018 was performed.The children with hepatitis syndrome were divided into the biliary atresia group( n=45) and non- biliary atresia group( n=30). Thirty children with hyperbilirubinemia were selected as the control group.Shear wave speed (SWS) of all infants was collected by ARFI ultrasound and compared among 3 groups.Receiver ope-rating characteristic curve(ROC curve) was used to analyze the optimal threshold value for SWS in the diagnosis of biliary atresia. Results:The mean SWS values in the biliary atresia group, non-biliary atresia group and the control group were (1.79±0.29) m/s, (1.26±0.12) m/s and (1.08±0.06) m/s, respectively.Compared with the control group, the mean SWS values in the biliary atresia group and non-biliary atresia group were significantly higher ( t=165.43, 15.75, all P<0.05). The mean SWS value in the non-biliary atresia group was significantly lower than that in the biliary atresia group ( t=90.27, P<0.05). With the non-biliary atresia group as reference, the area under the ROC curve of SWS for diagnosis of biliary atresia was 0.98(95% CI: 0.95-1.00), the optimal threshold was 1.45 m/s, and the sensitivity and specificity were 88.9% and 96.7%, respectively. Conclusions:Rapid non-invasive ARFI elastography is effective in the diagnosis of biliary atresia, and thus has important value for early diagnosis and treatment in clinical practice.

Objective: To analyze vaccination situation of oral live attenuated rotavirus vaccine (LLR strain) among children from six provinces in China. Methods: In 2014, we selected 12 counties in Guangdong, Jiangsu, Chongqing, Jiangxi, Heilongjiang and Gansu provinces by using stratified cluster random sampling method and extract information of children born from January 1, 2008 to December 31, 2012 from Children's Immunization Information System. We investigated ten children of each birth cohort in each county by checking the vaccination certification, and a total of 606 children were investigated. A survey was conducted to check the information of the children's vaccination certification with the data of Children's Immunization Information System by questionnaire including the basic information (province, county, name, gender, birth date, etc) and the rotavirus vaccination (vaccination date, dose, etc) to analyze the rotavirus vaccination situation. Results: 340 of 606 children were male. There were 121, 124, 122, 119 and 120 children born in 2008-2012, respectively. The proportions of the first and the second dose of rotavirus vaccination were 32.8% (199) and 9.7% (59). The proportion of the third dose of rotavirus vaccination among children born between 2008 and 2010 was 3.5% (13) since children born in 2011 and 2012 did not reach the age of third dose vaccination. The proportion of the first dose of rotavirus vaccination in high, middle and low per capita disposable income areas was 45.0% (91), 37.7% (77) and 15.5% (31) respectively (χ²= 43.15, P<0.001). Among 199 children vaccinated with the first dose of vaccine, the vaccination age mainly concentrated in 2 to 21 months, of which the peak was 5 to 13 months (66.8%, 133). The intervals between 2 doses of vaccination were mainly from 12 to 13 months (42.4%, 25) among the 59 children who received at least 2 doses of vaccine. In the 13 children vaccinated with 3 doses, the intervals between the second and the third dose were 12 months (5). Of the 271 doses of rotavirus vaccine vaccinated during 2008-2014, 34.7% (94 doses) were vaccinated in June-August, 88 were vaccinated simultaneously with 18 other vaccines, accounting for 32.5% of the total. Of the 18 other vaccines, inactivated vaccines such as diphtheria vaccine (30 doses), Hib vaccine (14 doses), group A meningitis vaccine (10 doses) were predominant. Conclusion The proportion of rotavirus vaccination was low and the vaccination age was relatively late. The vaccination mode was different from the recommendation of WHO. It is recommended that routine immunization of rotavirus vaccines should be carried out in early-months of children.

Objective To study the clinical features and risk factors of acute pulmonary reperfusion injury after operation in neonates with severe pulmonary stenosis or pulmonary atresia.Method From February 2014 to February 2018,a retrospective analysis was performed in patients with critical pulmonary stenosis or pulmonary atresia who received percutaneous balloon pulmonary valvuloplasty (PBPV) in the neonatal intensive care unit of our hospital.Clinical characteristics,perioperative cardiac structure,hemodynamic data and biochemical results were collected.The neonates were assigned into injury group if they had acute lung reperfusion injury,and non-injury group if not.The risk factors of acute lung reperfusion injury were analyzed using multi-variate Logistic regression model.Result A total of 32 patients (24 prenatal diagnosis and 8 postnatal diagnosis) with severe pulmonary stenosis or pulmonary atresia with intact ventricular septum were enrolled.The main manifestations were dyspnea and cyanosis.Intravenous prostaglandin E was administered to keep the ductus arteriosus open.The age of operation ranged from 1 to 52 days and the median age was 7.5 days.Postoperative acute lung reperfusion injury occurred in 7 cases (21.9％).Preoperative and intraoperative pulmonary valve annulus diameter,balloon diameter,preoperative hemoglobin,hematocrit and blood albumin were significantly lower in the injury group.The operation duration,total length of hospital stay and postoperative duration were longer than in the non-injury group,the differences were statistically significant (P ＜ 0.05).Multi-variate Logistic regression analysis showed that the diameter of pulmonary valve annulus (OR =5.814,95％CI 1.106 ～30.568),preoperative blood albumin (OR =1.361,95％ CI 1.063 ～ 1.742),and hematocrit (OR =1.173,95％ CI 1.010 ～ 1.363) were risk factors of acute lung reperfusion injury,with statistically significant differences (P ＜ 0.05).Conclusion Acute lung reperfusion injury is one of the common complications after the operation of severe pulmonary stenosis or pulmonary atresia.The severity of pulmonary valve annulus stenosis,preoperative hematocrit and blood albumin level may be the risk factors of postoperative acute lung reperfusion injury.

Objective To analyze the characteristics and changes in the disease spectrum of Air Force(AF) servicemen in order to provide reference for the determinatron of the overall level of health of AF and priorities of disease prevention and control.Methods The data of outpatient and inpatient diseases between 2009 and 2013 in AF was collected and analyzed statistically according to the International Classification of Diseases-9(ICD-9),and statistical description was performed with SPSS18.0.Results Between 2009 and 2013,unit B had the highest number of outpatients and inpatients,accounting for 47.74% and 39.64% respectively.The upper respiratory tract infections,gastroenteritis/gastritis,chronic low back pain,skin diseases,nasal sinusitis,training injury,trauma,hemorrhoids,varicocele and stone diseases were the common and frequently occurring diseases in AF,which were the top ten in the disease spectrum.Among them,the incidence and admission rate of skin diseases kept declining.However,the incidence of gastroenteritis/gastritis in unit A,the incidence and admission rate of chronic low back pain in unit B and D,the incidence of injury in unit D,as well as the incidence of neurological headache and hypertension in unit C and D were higher than in other units.Conclusion Respiratory system disease,and occupation-related diseases such as low back pain,training injuries,trauma,skin disease and digestive system disease are the focus of health care in AF.Health education and health promotion for these diseases should be improved,and health intervention for key populations should be enhanced.

Objective To study the current situation of fast-track surgery nursing in the department of urology,in order to provide theory basis for nursing clinical research and practice in the development of urology in the future.Methods The data were collected from American PubMed database,domestic Wanfang database and CNKI from May to August 2016. The bibliometric analysis was used to analyze all collected research literatures about fast-track surgery nursing in the department of urology according to country,year,disease classification,publication and so on.Results From January 1st,1995 to August 17th,2016,a total of 96 research articles about fast-track surgery nursing in the department of urology were collected from the databases of PubMed,Wanfang and CNKI. There were 73 Chinese articles,accounting for 76.04%. The research themes were kidney disease (41.67%),bladder disease (35.42%) and prostate disease (14.58%). The postoperative fast-track surgery of urinary system tumor accounted for 65% in the domestic and foreign research.Conclusions The fast-track surgery of kidney and bladder diseases is the hotspot of study. The renal tumor radical operation and the urinary bladder carcinoma radical operation with urinary diversion are hot research directions of fast-track surgery. Randomized control method used in clinical patients is the main research method for the application of fast-track surgery concept.

Objective To compare the left ventricular function parameters of patients with sick sinus syndrome ( SSS ) and DDD pacemaker implantation during atrioventricular conduction ( AVC ) and right ventricular apex pacing ( RVAP ) mode . Methods Forty‐six consecutive patients with SSS who had undergone DDD pacemaker implantation were studied . Fifty volunteers were included as control group . Changing from AVC to RVAP mode ,the acute effect on echocardiographic parameters ,including LVEF , parameters of aortic/pulmonary artery pulse wave Doppler ,and parameters of left ventricular twist by speckle tracking imaging were measured respectively . Pacemaker implantation duration and cumulative ventricular pacing proportion ( Cum% VP) were recorded . The relationships of pacemaker parameter and above left ventricular function parameters were analyzed . Results Compared with control group ,values of peak rotation in LV apex and LV twist were significantly lower during AVC and RVAP mode . The value of peak rotation in LV base showed no significant difference between three groups .Apical‐basal rotation delay during RVAP was significantly longer than those during AVC and in control group respectively ( P <0 .05) . LVEF during RVAP decreased statistically ( P< 0 .05 ) ,but showed no difference during AVC , compared with the control group . The peak LV twist related positively with LVEF ,and negatively with Cum% VP . Conclusions RVA pacing decreases left ventricular function , which is independent of asynchrony contraction patterns caused by pacing . LVEF ,apical rotation and LV twist are more sensitive to demonstrate the LV dysfunction in patients with pacemaker implantation . LV twist related negatively with Cum% VP .

Objective Toinvestigate the related risk factors of newly diagnosed diabetes among residents aged over 40 years in Nanjing City , and to provide evidence for diabetes prevention. Methods The clinical data were collected from the diabetes epidemiologic investigation among residents aged 40 -79 years from 6 communities in Nanjing City. Univariate and multiple logistic regression analyses were performed to analyze the potential risk factors for newly diagnosed diabetes. Results The prevalence rate of new diagnosed diabetes from 8039 subjects was 10.87%. A higher prevalence rate of new diagnosed diabetes was found in male than that in female (13.15% vs. 9.74%, P < 0.01). Multiple logistic regression analyses revealed that the main risk factors for newly diagnosed diabetes were male, age, family history, body mass index (BMI) and less physical activity after adjusting other factors (adjusted OR 1.339-1.862, P < 0.05). Conclusions Male, age, family history, body mass index (BMI) and less physical activity may be the main risk factors for diabetes among residents in Nanjing City.