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Objective:To investigate the ultrasonographic features and evolution of thyroid shrinking nodules in order to improve the differential diagnosis and management strategy and avoid unnecessary biopsy.Methods:A total of 245 patients with old bleeding of benign thyroid nodules diagnosed via fine needle aspiration cytology (FNAC) from May 2015 to July 2020 in the southern part of the Shanghai General Hospital Affiliated to the Medical College of Shanghai Jiaotong University, including 263 nodules. The sonographic parameters such as size, shape, aspect ratio, echo, edge, boundary, periphery, halo, calcification, posterior echo enhancement and posterior acoustic attenuation of nodules were analyzed retrospectively, and the ultrasonic appearances of nodules were classified; 41 nodules from 40 patients, who did ultrasound examinations more than twice and had both complete ultrasonographic data, were compared and then classified in order to explore the evolution rules of the nodules.Results:Two hundred and sixty-three thyroid shrinking nodules in 245 cases were classified into 4 types: "cystic wall shrinkage sign" type(71.48%, 188/263), "carcinoma-like" type (22.05%, 58/263), "inflammation-like" type(3.04%, 8/263) and "undefined atypical solid nodules" type(3.42%, 9/263). Of the 41 consecutive follow-up nodules, 37 cases showed obvious cystic wall shrinkage sign, and 7 of them developed into "carcinoma-like" type and 6 cases into "inflammation-like" type.Conclusions:The ultrasonographic appearance of thyroid shrinking nodules is a dynamic process, which can be divided into 4 types: "cystic wall shrinkage sign" , "carcinoma-like" , "inflammation-like" and "undefined atypical solid nodules" types. The "cystic wall shrinkage sign" type is typical and common. The "cystic wall shrinkage sign" type can develope into the "carcinoma-like" type or the "inflammation-like" type.
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Acute pancreatitis (AP) is an acute inflammatory and cell-damaging process of the pancreas. In this paper, using the AP onset location and its characteristics combined with review of the ancient and modern literatures and summary of the clinical practices, the professor Chen Qiaolin's academic ideas and clinical experiences in treating AP are introduced and demonstrated. Dr. Chen believes that the development of AP is a dynamic process, the key point is to grasp the Shaoyang syndrome complicated with Yangming, the internal administration of the self-modified Dachaihu decoction is the basic therapy accompanied by applying paste-like Traditional Chinese Medicine TCM attached on the acupoints and acupuncture for comprehensive treatment of AP, the therapeutic result is confirmed and its summary is as follows.
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Objective To compare the clinical efficacy of gabapentin and carbamazepine in the treatment of elderly patients with primary trigeminal neuralgia.Methods 96 cases of elderly patients with primary trigeminal from March 2014 to March 2016 were selected and randomly divided into gabapentin group and carbamazepine group, which each group with 48 cases.The clinical efficacy, adverse reactions and changes of pain, insomnia, anxiety, depression status and oxidative stress indexes were compared.Results After treatment, there was no significant difference in total effective rate between two groups.And the excellence rates in gabapentin group was 60.4%, which significantly higher than that in carbamazepine group with 37.5%, the difference was statistically significant ( P <0.05 ) .After treatment, VAS score and sleep disturbance score in gabapentin group were significantly lower than those in carbamazepine group, the difference was statistically significant (P<0.05), and SAS score and SDS score were also significantly lower than those in carbamazepine group, the difference was statistically significant (P<0.05).The adverse reactions rates in gabapentin group was 22.9%, which significantly higher than that in carbamazepine group with 43.8%, the difference was statistically significant ( P <0.05 ) . Conclusion Compared with carbamazepine, gabapentin in the treatment of elderly patients with primary trigeminal neuralgia can enhance clinical effect , improve pain, insomnia, anxiety, depression status.
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Infectious disease has replaced methodology with the development of subject. Special topic combined with case teaching method is introduced into infectious disease. Practice has showed that,compared with traditional teaching method, special topic combined with case teaching method can arouse students' leaning interest, improve comprehensive analytical ability and innovate clinical performing skills.It is an effective clinical teaching method.