Humans ; Artificial Intelligence ; Lung Neoplasms/pathology* ; Mediastinum/pathology* ; Lymph Nodes/pathology* ; Neoplasm Staging ; Lymph Node Excision

Objective:To investigate the occurrence of inadequate specimens of thyroid nodule fine needle non-aspiration cytology and its possible influencing factors.Methods:Clinical data of 1571 patients with FNAC of 1638 thyroid nodules were analyzed retrospectively, according to whether the FNAC specimen were adequate or not, all cases were divided into adequate group and inadequate group. The related influencing factors on inadequate specimen were analyzed by univariate analysis and multivariate logistic regression.Results:Inadequate specimens occurred in 301 of 1638 (18.4%) nodules. Logistic regression analysis showed that the influencing factors of overall specimen adequacy included operator experience ( P=0.00) , nodules size≤0.5 cm ( P=0.00) , eggshell calcification ( P=0.00) , and cystic ( P=0.00) . Excluding the impact of operator experience, the influencing factors of specimen adequacy included nodules size≤0.5 cm ( P=0.00) , eggshell calcification ( P=0.00) , and cystic ( P=0.00) . Conclusions:Operator experience, nodules size≤0.5 cm, cystic, together with eggshell calcification are influencing factors of specimen adequacy of fine needle non-aspiration cytology in thyroid nodules. For experienced operators, what restrict specimen adequacy is the limitation of FNAC technique. For inexperienced operators, what restrict specimen adequacy is operator’s experience.

The outbreak of coronavirus disease 2019 (COVID-19) has spread rapidly around the world. As of May 30, 2020, a total of 84 568 confirmed COVID-19 cases have been recorded in China, with a mortality rate of approximately 5.5%. Taizhou is a prefecture-level city in Zhejiang Province. A total of 146 cases were diagnosed in this epidemic, with a fatality rate of 0%. This condition is due to the establishment of an "Internet +" diagnosis and treatment model based on online medical application (APP), telemedicine, WeChat service, and consultation hotline in Taizhou. Taizhou led in opening the "COVID-19 Prevention and Treatment Special Line" in China, which is conducive to pre-hospital screening, suppressing social panic, and clinical support. Hospitals also carried out related online lectures and popularization of science. We summarize Taizhou's COVID-19 prevention and control experience with telemedicine features, with a view to providing reference for the control of the epidemic at home and abroad.
Betacoronavirus ; China ; Coronavirus Infections ; prevention & control ; Humans ; Internet ; Pandemics ; prevention & control ; Pneumonia, Viral ; prevention & control ; Telemedicine ; organization & administration

For effective resistance to virus attack and infection, reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. This paper summarizes the development causes, common locations, and prevention ways about the device related pressure injuries on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the nursing strategy for device related pressure injuries and other nursing strategy is proposed to take care efficiently the device related pressure injuries. Meantime, a corresponding nursing strategy is also suggested to deal with the correlative skin diseases during the application of medical-grade protective equipment. These paper aims to provide reference for the prevention of device related pressure injuries and the care of skin-related diseases for clinical working staff, especially to the respectable personnel in front line of fighting against Corona virus disease 2019.

For effective resistance to virus attack and infection and reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. The paper summarizes the occurrence causes, common locations, and prevention ways about the device related pressure ulcers on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the prevention and nursing strategies for device related pressure ulcers and other related skin injuries during application of medical-grade protective equipment. The paper aims to provide reference for the prevention and nursing of device related pressure ulcers and related skin diseases for clinical medical staff, especially to the respectable personnel in front line of fighting against coronavirus disease 2019.

Studies examining the trends in public trust in physicians have provided a considerable amount of valuable policy implications for policymakers compared with cross-sectional studies on this topic in many countries. This study investigated changes in public trust in physicians in China based on two cross-sectional national surveys conducted in 2011 and 2016 and identified the determinants of these changes. The results indicated 83.4% of respondents in 2011 reported trust or strong trust in physicians in China, which decreased to 64.2% by 2016. The results of ordinal logistic regression demonstrated that public trust in physicians in China had decreased significantly from 2011 to 2016 (P< 0.001) after adjusting for other independent variables. Self-reported health status, self-rated happiness, and self-identified social class were all associated positively with public trust in physicians in China. The results also confirmed that decreasing public satisfaction with the most recent treatment experience was the major determinant of decreasing public trust in physicians in China. The findings of this study suggest that decreasing public trust in physicians deserves considerable attention from national policymakers and that improving satisfaction with treatment experiences would be the most effective strategy for enhancing public trust in physicians in China.

Reforms in public hospitals are among the most important improvements in China's health care system over the last two decades. However, the reforms that should be implemented in public hospitals are unclear. Thus, a feasible direction of reforms in Chinese public hospitals is suggested and reliable policy suggestions are provided for the government to reform public hospitals. The data used in this study were mainly derived from a qualitative study. Focus group discussions and in-depth interviews were conducted in Shanghai, Guangdong, and Gansu between May and December 2014. Government funding accounted for approximately eight percent of the total annual revenue of public hospitals in China, and the insufficient government subsidy considerably affects the operation mechanism of public hospitals. However, solely increasing this subsidy cannot address the inappropriate incentives of public hospitals in China. The most crucial step in setting the direction of reforms in public hospitals in China is transforming inappropriate incentives by implementing a new evaluation index system for directors and physicians in public hospitals.
China ; Focus Groups ; Health Care Reform ; organization & administration ; Health Personnel ; economics ; Hospitals, Public ; classification ; economics ; trends ; Humans ; Qualitative Research

Objective: To explore the effects of multidisciplinary comprehensive intervention in integrated treatment of patients with extremely severe burns. Methods: One hundred and ten patients hospitalized in our center from July 2013 to August 2017 met the criteria for inclusion in this study, and their medical records were retrospectively analyzed. According to the medical model at that time, 56 patients hospitalized from July 2013 to July 2015 received routine comprehensive treatment led by doctors, and they were included in the conventional intervention group. From August 2015 to August 2017, 54 patients were treated with integrated multidisciplinary interventions performed by a team consisting of physicians, intensive care nurses, burn nurses, intravenous infusion nurses, wound stoma nurses, and rehabilitation therapists, and they were included in the integrated intervention group. Acute Physiological and Chronic Health Assessment Ⅱ (APACHE Ⅱ) scores on admission and 4 weeks after treatment, incidences of pressure injury, wound sepsis, lung infection, and catheter-related infection during hospitalization, length of stay in intensive care unit (ICU) and total length of hospital stay, and Abbreviated Burn Specific Health Scale (BSHS-A) scores at discharge and 3 months after discharge were analyzed. Data were processed with t-test and chi-square test. Results: The APACHE Ⅱ scores of patients in the two groups were close on admission (t=0.573, P>0.05). Four weeks after treatment, the APACHE Ⅱ scores of patients in the two groups were obviously lower than those on admission within the same group (t=5.697, 4.853, P<0.01), and the score of the integrated intervention group was obviously lower than that of the conventional intervention group (t=2.170, P<0.05). No pressure injury was observed in patients of any group during hospitalization. The incidences of wound sepsis, lung infection, and catheter-related infection of patients in the integrated intervention group were 18.5% (10/54), 3.7% (2/54), and 9.3% (5/54), respectively, significantly lower than 42.9% (24/56), 21.4% (12/56), and 26.8% (15/56) of the conventional intervention group, χ²=4.073, 6.075, 3.962, P<0.05. The length of stay in ICU of patients in the integrated intervention group was (50±5) d, obviously shorter than (62±4) d of the conventional intervention group (t=2.852, P<0.01). The total length of hospital stay of patients in the integrated intervention group was (115±8) d, obviously shorter than (140±7) d of the conventional intervention group (t=16.885, P<0.01). At discharge and 3 months after discharge, the scores of BSHS-A, physical function, psychological function, and general health status of 50 patients in the integrated intervention group were significantly higher than those of 48 patients in the conventional intervention group (t=2.886, 3.126, 2.416, 2.544, 2.033, 3.471, 2.588, 2.210, P<0.05 or P<0.01), while the scores of social function of patients in the two groups were close (t=1.570, 1.350, P>0.05). Conclusions Integrative treatment of patients with extremely severe burns by multidisciplinary comprehensive intervention can significantly alleviate the severity of burns, reduce the incidences of wound sepsis, lung infection, and catheter-related infection, shorten the length of stay in ICU and total length of hospital stay, and improve the quality of life.

RING finger protein 13 (RNF13) is a novel E3 ubiquitin ligase whose expression is associated with cancer development. However, its specific role in cancer progression and metastasis remains unclear. Here, a B16F10/LLC experimental pulmonary metastatic model was developed to examine the formation of metastatic foci in the lung. A greater number of tumor colonies were observed in the lungs of RNF13-knockout (KO) mice than in their wild-type (WT) littermates, whereas no significant differences in tumor size were observed between the two groups. In short-term experiments, the number of fluorescently-labeled B16F10 cells increased remarkably in RNF13-KO lungs at early time points, whereas clearance of tumor cells from the blood was not affected. These results indicated that RNF13 may inhibit the colonization of B16F10 cells in the lung. Assessment of the concentration of various cytokines in tumor bearing lungs and blood did not detect significant differences between the blood of RNF13-KO and WT mice; however the levels of GM-CSF were significantly reduced in RNF13-KO tumor bearing lungs, which may have guided more B16F10 cells to migrate to the lungs. This was confirmed by lower GM-CSF concentrations in conditioned media from the culture of RNF13-KO lung slices. Collectively, our results suggest that host RNF13 affects the concentration of GM-CSF in tumor-bearing lungs, leading to a reduction in the colonization of metastatic tumor cells in the lung.
Animals ; Cell Line, Tumor ; Gene Knockout Techniques ; Granulocyte-Macrophage Colony-Stimulating Factor ; metabolism ; Lung ; metabolism ; pathology ; Lung Neoplasms ; pathology ; Mice ; Mice, Knockout ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Ubiquitin-Protein Ligases ; deficiency ; genetics

Objective :To investigate the clinical effect of prophylactic terminal ileostomy for protecting high-risk colorectal anastomotic stoma .Methods :Dixon operation combined with prophylactic terminal ileostomy was performed for even colorectal cancer patients with high risk of colorectal anastomotic leakage during February 2014 and October 2014 .The occurrence and outcome of complications related to anastomotic stoma were observed .Results : All the patients were dismissed from 7 to 10 days after operation .Anastomotic leakages occurred in 2 cases ,and both were slight leakages with no subjective symptom . And no specific surgical treatment was performed for them .Anastomotic bleeding occurred in 1 case and the bleeding was stopped by conservative treatment . There was no occurrence of leakage . Conclusions : Prophylactic terminal ileostomy is effective for protecting high-risk colorectal anastomotic stoma from leakage .So it is worthy of clinical promotion .