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:To analyze the clinicopathological features of giant ovarian masses(mean diameter≥10 cm)and analyze the clinical characteristics of patients in different age groups.Methods:The clinicopathological characteristics of 311 patients diagnosed with giant ovarian masses by surgery at Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University from January 2014 to December 2022 were retrospectively analyzed.Patients were further stratified by age and mass size to compare the differences of clinical and patho-logical features among different age groups and different mass diameter groups.Results:①The median age of thepatients were 44(24,60)years old.The first symptoms were as follows:ovarian mass discovered during physi-cal examination,abdominal pain,bloating,conscious abdominal distension,and symptoms of compression.②The surgical methods were as follows:unilateral oophorectomy(30.5％,95/311),ovarian cystectomy(28.9％,90/311),tumor staging or cytoreductive surgery(28.0％,87/311),total hysterectomy with bilateral adnexectomy(12.5％,39/311).③The pathological types were benign(49.5％,154/311),malignant(31.8％,99/311)and borderline(18.7％,58/311).④ Patients complained abdominal distension in＜20 years old group were signifi-cantly higher than the other two groups(P＜0.05).The ovarian resection rate in the＞50-year-old group was higher than that of the other two groups(P＜0.05),and the rate of unilateral ovarian resection in the＜20-year-old group was still as high as 30.1％(15/49).⑤ The size of the mass correlated with the duration of the disease.When the disease course was between 1 to 6 months,the mass diameter line＞30 cm was the most common(P＜0.05).The incidence of borderline tumors in the＞30 cm group was significantly higher than that in the other two groups,and the difference was statistically significant(P＜0.05).Conclusions:Ovarian mucinous and mucinous borderline tumors are the most common types of giant adnexal masses.The size of the mass tends to increase with the prolongation of the disease course.The incidence of borderline tumors increases with the in-crease of mass.Health education for young people should be strengthened.When abdominal pain,abdominal bloating,especially lower abdominal distension occurs,they should seek medical treatment in time to avoid adnex-ectomy due to borderline tumors.

Dental resin materials have been widely used in the treatment of dental defects. However, the polymerization shrinkage of the resin materials tends to cause microleakage and accumulation of bacterial plaque, which leads to secondary dental caries. Endowing dental resin with antibacterial properties is an important way to solve this problem. Adding antibacterial agents to dental resin is the main method to give it antibacterial properties. Antimicrobial agents are mainly divided into three types: release type, non-release type and mixed type. In terms of antibacterial effects, the selection and addition of antibacterial agents will affect the antibacterial and mechanical properties of dental resin materials; and the long-term antibacterial effect of antimicrobial agents in the oral cavity remains to be verified; as antimicrobial agents or other environmental factors can lead to drug resistance and even dormant persistent bacteria. In recent years, researchers have been committed to improving the antibacterial effect by modifying antibacterial agents. The sustained release of antimicrobial agents via carriers is also the main research direction. This paper reviews the research progress on the antibacterial properties of dental resin materials.

Objective:To investigate clinical significance and related factors of magnetic resonance hyperintense vessel sign (HVS).Methods:The clinical data and related imaging parameters of 109 patients with acute anterior circulation occlusion cerebral infarction, who admitted to Northern Theater Command General Hospital of People′s Liberation Army from April 2017 to August 2019, were analyzed retrospectively. Brain magnetic resonance imaging (MRI) examinations including fluid attenuated inversion recovery (FLAIR), diffusion weighted imaging (DWI) and three dimensional time of flight magnetic resonance angiography (3D TOF MRA) sequences within 24 hours of onset were performed. According to the distribution range of HVS in FLAIR sequence, the patients were divided into four grades (0, 1, 2 and 3), grades 0 and 1 belonging to HVS low grade group, and grades 2 and 3 HVS high grade group. Univariate and multivariate analyses were made to explore related factors of HVS. Fifty-two patients who completed baseline CT within six hours of onset before MRI examination were performed CT-Alberta Stroke Program Early CT Score (CT-ASPECTS) and DWI-Alberta Stroke Program Early CT Score (DWI-ASPECTS).The difference between CT-ASPECTS and DWI-ASPECTS was calculated. When the difference of ASPECTS ≤1, they were categorized as ASPECTS unchanged group (AN group); when the difference of ASPECTS>1, they were categorized as ASPECTS changed group (AY group). These two groups were compared to explore whether there was any difference in HVS grade, and Spearman correlation analysis was performed to investigate the relationship between HVS grade and the difference of ASPECTS.Results:The difference of hyperlipidemia, TOAST classification (large artery atherosclerosis (LAA), other etiology (SOE) or undetermined etiology (SUE)) and Willis circle classification (types Ⅰ, Ⅱ, Ⅲ and Ⅳ) between HVS groups were remarkable (58.6% (34/58) vs 37.3% (19/51), χ2=4.959, P=0.026; 23/5/23 vs 43/1/14, P=0.004; 3/14/12/22 vs 7/29/14/8, χ2=13.124, P=0.004). Other clinical factors and the locations of vessel occlusion did not show significant difference ( P>0.05). Multivariate Logistic regression analysis indicated that LAA in TOAST classification (LAA vs SOE or SUE, OR=3.054, 95% CI1.257-7.422, P=0.014), Willis circle type Ⅰ (type Ⅰ vs type Ⅳ, OR=5.494, 95% CI1.074-28.091, P=0.041), and type Ⅱ (type Ⅱ vs type Ⅳ, OR=5.571, 95% CI1.895-16.372, P=0.002) were independent related factors to stimulate wide distribution of HVS. The grades of HVS were significantly different between the AN group and the AY group (1/15 vs18/18, χ2=9.114, P=0.002). Spearman correlation analysis showed that HVS grade was negatively correlated with the difference of ASPECTS ( r=-0.573, P<0.001). Conclusions:Both TOAST and Willis circle classifications are crucial factors affecting HVS distribution. HVS distribution range reflects the status of collateral compensatory. Recognizing HVS may help to evaluate the progress of early cerebral infarction volume.

Objective:To investigate the adult thyroid structural abnormalities and epidemiological characteristics in different regions of Heilongjiang Province.Methods:From December 2017 to November 2018, 30 survey sites were selected in 13 prefecture-level cities under the jurisdiction of Heilongjiang Province by the population probability sampling (PPS) method, and 120 local residents aged 20 to 70 who lived for more than 1 year in the local area were selected from each survey site for thyroid ultrasound examination. The occurrence of thyroid structural abnormalities in different genders, ages and regions were analyzed.Results:A total of 3 870 residents were investigated, including 1 248 males and 2 622 females, aged (48.3 ± 12.6) years; 2 075 urban residents and 1 795 rural residents. A total of 2 144 cases of thyroid structural abnormalities were detected, with a total detection rate of 55.40% (2 144/3 870); among them, 1 476 cases of thyroid focal nodular lesions, 359 cases of diffuse lesions, and 309 cases of diffuse lesions with focal nodules, the detection rates were 38.14%, 9.28%, and 7.98%, respectively. The detection rate of thyroid structural abnormalities was 61.25% (1 606/2 622) in women and 43.11% (538/1 248) in men, the difference was statistically significant (χ 2=111.899, P < 0.01). There was significant difference in the total detection rate of thyroid structural abnormalities among different age groups (χ 2=185.959, P < 0.01); and with the increase of age, the total detection rate of thyroid structural abnormalities showed an upward trend (χ 2trend=173.576, P < 0.01). There was significant difference in the total detection rate of thyroid structural abnormalities in adults among different prefecture-level cities (χ 2=108.487, P < 0.01); but there was no significant difference in the total detection rate of thyroid structural abnormalities between urban and rural (χ 2=0.103, P > 0.05). Conclusions:The main thyroid structural abnormalities in Heilongjiang Province are focal nodular lesions. The detection rate of women is higher than that of men, and the older the age, the higher the detection rate. There are differences in the detection rate of thyroid structural abnormalities in adults of different prefecture-level cities, but there is no significant difference between urban and rural.

Objective To explore the dynamic trend and main influencing factors of the prevalence of subthreshold depression after stroke,so as to provide reference for the primary prevention and nursing intervention of post-stroke depression. Methods A total of 123 stroke patients admitted to the department of neurology of Daqing People's Hospital from September 2017 to June 2018 were selected by convenience sampling method. Major Depressive Disorder Scale (CES-D), Hamilton Depression Scale (HAMD-17), Behavioral Inhibition System and Behavioral Activation System Scale (BIS/BAS) and National Institutes of Health Stroke Scale (NIHSS) were applied in the investigation. Results The prevalence of subthreshold depression after stroke at baseline, 3 months and 6 months was 25.6%,18.6% and 20.4% respectively, and there was no statistical significant in the difference in prevalence at each time point (P＞ 0.05). The results of regression analysis showed that, at the time point of 2 weeks after stroke, gender, age and behavioral activation level were the main factors of subthreshold depression after stroke; after 3 months, age and behavioral activation level were the main factors of subthreshold depression after stroke; after 6 months, the number of complications and the level of behavioral activation were the main factors of subthreshold depression after stroke. Conclusions The prevalence rate of post-stroke subthreshold depression decreased first and then increased with time. The main factors of post-stroke subthreshold depression were different at each time point, and medical staff should treat differently according to different time points, so as to achieve the primary prevention of post-stroke depression.

OBJECTIVE:To establish a method for the determination of related substances in Methylphenidate hydrochloride for injection. METHODS:HPLC method was adopted. The determination was performed on Waters symmetry C18 column with mo-bile phase consisted of methanol-0.01 mol/L potassium dihydrogen phosphate solution(60:40,V/V)at the flow rate of 1.0 mL/min. The detection wavelength was set at 210 nm,the column temperature was 35 ℃ and sample size was 10 μL. RESULTS:The linear range of impurity A and B were 0.02-3.0 μg/mL(r=0.9998). The limits of quantitation were 0.2,0.6 ng,and the limits of detec-tion were 0.06,0.2 ng,respectively. RSDs of precision,stability and reproducibility were all lower than 2.0%;recoveries were 98.2%-100.0%(RSD=0.56%,n=9),98.0%-100.3%(RSD=0.70%,n=9),respectively. CONCLUSIONS:The method is sim-ple,accurate and suitable for the determination of related substance in Methylphenidate hydrochloride for injection.

Objective To investigate the risk factors of hypogonadism in male type 2 diabetic patients.Methods A total of 213 male patients with type 2 diabetes were enrolled and divided into low testosterone group (n=75) and normal testosterone group (n=138). Blood pressure, blood glucose, blood lipids, serum insulin and sex hormones including total testosterone (TT), sex hormone binding globulin (SHBG), progesterone, prolactin, estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone (DHEA) were measured in all patients.The correlations between the metabolic index and sex hormone levels were analyzed.Results Compared with normal testosterone group, body mass index (BMI), fasting insulin (FINS), and homeostasis model assessment insulin resistance (HOMA-IR) levels were significantly increased in low testosterone group(all P<0.05)while LH, FSH, and SHBG levels were significantly decreased(all P<0.05).Pearson correlation analysis showed that TT was negatively correlated with FINS and HOMA-IR(r=-0.142,-0.154, both P<0.05)while positively correlated with LH and FSH (r=0.157, 0.138, both P<0.05).TT level in patients with metabolic syndrome(MS) was significantly decreased (P<0.05).A multiple logistic regression analysis revealed that BMI, MS, HOMA-IR, and LH were significant independent risk factors for hypogonadism.Conclusions Hypogonadism often occurs in male patients with type 2 diabetes,especially in patients with MS.BMI, HOMA-IR, LH, and MS are risk factors for hypogonadism in male type 2 diabetic patients.

Objective To explore the mechanism of tripterygium wilfordii polyglycoside tablets for elderly patients with relapsing refractory immune thrombocytopenic purpura (ITP),and to seek the theoretical basis for Chinese medicine treatment of this disease.Methods The clinical data of 79 patients with relapsing refractory ITP were retrospectively analyzed.According to whether the combined use of tripterygium wilfordii polyglycoside,they were divided into the control group (35 cases) and the observation group (44 cases).The control group was treated with platelet and tranexamic acid,sulfasalazine,sulforaphane sodium,hemagglutinin and other symptomatic hemostasis treatment.The observation group in symptomatic hemostasis support on the basis of treatment with tripterygium wilfordii polyglycoside tablets.The CD4+/CD8+ ratio and CD4+ CD25+ Treg expression were compared between the two groups.Results The CD4+/CD8+ ratio,CD4+ CD25+ Treg and platelet count in the control group before treatmentwere (0.96 ± 0.36),(1.21 ± 0.67) ％,(13.14 ± 6.92) × 109/L,respectively,which of the observation group were (0.92 ± 0.37),(1.19 ± 0.59) ％,(11.51 ± 6.21) × 109/L,respectively,there were no statistically significant differences between the two groups (all P ＞ 0.05).The CD4+/CD8+ ratios in peripheral blood of the observation group at 2 weeks,3 weeks and 4 weeks after treatmentwere (1.04 ±0.56),(1.55 ±0.34),(1.59 ±0.41),respectively,there were statistically significant differences between the two groups (t =9.994,9.797,all P ＜ 0.05).The CD4+ CD25+ Treg proportions in the observation group at 2 weeks,3 weeks and 4 weeks after treatmentwere (1.01 ± 0.61) ％,(1.06:±:0.57) ％,(5.92 ± 0.65) ％,respectively,there was statistically significant difference between the 4 weeks after treatment and before treatment(t =5.378,P ＜ 0.05).The CD4+/CD8+ ratios in the peripheral blood of the control group were (1.01 ±0.60),(0.89 ±0.50) and (0.96 ±0.51),respectively,and the CD4+ CD25+ Treg in control group at 2 weeks,3 weeks and 4 weeks after treatment proportions were (0.99 ±0.72)％,(1.15 ±0.66)％,(1.22 ±0.56)％,respectively,there were no statistically significant differences between before and after treatment (all P ＞0.05).There were statistically significant differences in the CD4+/CD8+ ratio and CD4+ CD25+ Treg expression between the observation group and control group at 4 weeks after treatment (t =8.589,P ＜ 0.01;t =2.369,P ＜ 0.05).There was no statistically significant difference in the platelet count between the two groups(P ＞ 0.05),but the symptoms of bleeding of the observation group was lighter at 3 weeks after treatment.Conclusion Tripterygium wilfordii polyglycoside improves the expression of CD4+/CD8+ and CD4+ CD25+ Treg in peripheral blood of elderly patients with relapsed or refractory ITP.It is an ideal drug for the treatment of relapsed and refractory ITP in the elderly,it is worth further study.

Objective:To investigate the application value of real-time ultrasound elastography in the treatment of fibroids radiofrequency ablation (RFA).Methods:Transvaginal ultrasonography,Real-time ultrasound elastography (RTE) and contrast-enhanced ultrasonography (CEUS) were performed on 34 patients with a total of 38 uterine fibroids who had the treatment of RFA before,1 hour and 3 months after the treatment of RFA.Detected the diameters of the lesions with the three methods of CEUS,RTE and 2D.Analysed the elastic image features and divided into groups,Measured the elastic strain ratio and compared the E/E0 in and between the group.The difference of lesion diameter between 2D,RTE and CEUS was compared.When the image of lesions showed blue and green was taken as the cirterion of incomplete ablation after RFA,conpared with CEUS,analysed the consistency of RTE and CEUS in evaluating the degree of ablation.Results:The lesions were divided into 3 groups according to the preoperative elastic image,with 8 (21.1％) in the blue group,20 (52.6％) in blue-based and 10 (26.3％) in green-based group.The difference was obvious in E/E0 between the 3 groups before RFA.There was no significant difference in E/E0 between 1 hour and 3 months after RFA (P ＞ 0.05).In each group the E/E0 of lesions were significantly increased at 1 hour and 3 months after the treatment of FRA,and the hardness of 3 months after RFA was harder than that of 1 hour after RFA(P＜0.05).The diameter measured by RTE was larger than that by 2D and CEUS before RFA(P＞0.05).The diameter measured by 2D was larger than that by RTE and CEUS at 1 hour after RFA (P＜0.05).No statistically significant difference was found in the lesion diameters among the three methods of2D,RTE and CEUS at 3 months after the treatment ofRFA (P＞0.05).CEUS and RTE had the basic consistent in the evaluation of lesions ablation degree at 1 hour (kappa=0.46) and 3 months (kappa=0.54) after the treatment of RFA.Conclusions:After RFA,the myoma gradually hardens,and RTE can reflect the change of the hardness,RTE can clearly show the boundary of uterine ftbroids especially after the treatment of RFA,can be used in the prediction of lesions ablation degree,so there was a certain application value of RTE used in RFA.