Diagnostic value of multimodal ultrasonography for thyroid nodules in thyroid imaging reporting and data system categories 3 to 5 / 中国辐射卫生

Objective To assess the value of multimodal ultrasonography for diagnosing thyroid nodules—atypia of undetermined significance (AUS) of thyroid imaging reporting and data system (TI-RADS) categories 3 to 5. Methods A total of 90 AUS thyroid nodules in TI-RADS 3-5 categories from 88 patients underwent conventional ultrasonography, ultrasound elastography, superb microvascular imaging, and multimodal ultrasonography at the same time. With fine needle aspiration biopsy results as the gold standard, the methods were compared in terms of the sensitivity, specificity, accuracy, false positive rate (FPR), false negative rate (FNR), and area under the receiver operating characteristic curve (AUC) for diagnosing thyroid nodules. Results There were no significant differences between patients with benign and those with malignant thyroid nodules in terms of sex, age, and nodule locations (all P > 0.05), but the proportion of thyroid nodules ≤ 1 cm in diameter was significantly higher for malignant thyroid nodules than for benign thyroid nodules (χ2=9.610, P=0.002). Compared with benign nodules, malignant nodules were significantly more frequent to have low-level echoes or very low-level echoes, a blurred margin, a vertical diameter/horizontal diameter ratio of > 1, and microcalcifications or no calcifications (all P < 0.05). An ultrasound elastography score of ≥ 3 and type III vascularity on superb microvascular imaging indicated a higher possibility of malignant thyroid nodules (both P < 0.001). The multivariable logistic regression analysis showed that the size, echogenicity, margin, and vertical diameter/horizontal diameter ratio, and superb microvascular imaging type of thyroid nodules were not significant markers for benign or malignant thyroid nodules (all P > 0.05), while microcalcifications/no calcifications and an ultrasound elastography score of ≥ 3 were independent risk factors for malignant AUS nodules (both P < 0.05). The diagnostic sensitivity, specificity, accuracy, FPR, and FNR of conventional ultrasonography for AUS nodules were 91.30%, 71.40%, 62.70%, 28.60%, and 8.70%, respectively; the values for ultrasound elastography were 85.50%, 66.70%, 52.20%, 33.30%, and 14.50%, respectively; the values for superb microvascular imaging were 66.70%, 76.20%, 42.90%, 23.80%, and 33.30%, respectively; and the values for multimodal ultrasonography were 75.20%, 92.50%, 67.70%, 24.80%, and 7.50%, respectively. For distinguishing between benign and malignant AUS nodules, the AUC values of conventional ultrasonography, ultrasound elastography, superb microvascular imaging, and multimodal ultrasonography were 0.866, 0.745, 0.774, and 0.918, respectively. Conclusion Multimodal ultrasonography shows better diagnostic efficacy for AUS nodules of TI-RADS 3-5 compared with conventional ultrasonography, ultrasound elastography, and superb microvascular imaging, which can facilitate the malignancy risk stratification and management of AUS thyroid nodules.

Diagnosis boundary values of metabolic syndrome obesity index for Children and adolescents / 中南大学学报(医学版)

Objective: To determine the distribution characteristics of waist circumference (WC), waist height ratio (WHtR) of 6–18 years olds in Guangzhou, and to put forward the WC and WHtR appropriate boundary values for 6–18 years olds on the basis of cardiovascular disease (CVD) risk factor assessment. Methods: We analyzed the height, weight, WC and its metabolic indication data (blood pressure, fasting blood glucose, and blood lipids) of 15 000 children in Guangzhou, aged 6–18, with the receiver-operating characteristic curve (ROC), and explored the best value point of WC and WHtRfor the prediction of cardiovascular diseases. Results: When the WC percent reached P85, and WHtR reached 0.48, the cardiovascular risk factors of fasting blood-glucose, blood pressure, and blood fat were signiifcantly higher. Conclusion: The 85th percentile value of WC and 0.48 of WHtR are the appropriate boundary values in increasing the cardiovascular disease risk factors in Chinese children and teenagers. WC and WHtR as a relatively simple inspection method, can well predict cardiovascular diseases, and be used in the conventional measuring items among students.

Application of Course Management in Disinfection and Sterilization in Hospital / 中华医院感染学杂志

OBJECTIVE To apply course management in disinfection and sterilization in hospital.METHODS The key points of disinfection and sterilization were investigated and found out.The flow of disinfection and sterilization was reconstructed,and the course management was actualized.RESULTS The hardware of disinfection and sterilization was improved,and the work efficiency and the percentage of pass were increased.CONCLUSIONS Course management is propitious to normal disinfection and sterilization in hospitial.

Application and Contamination of Disposable Syringes:Investigation and Analysis / 中华医院感染学杂志

OBJECTIVE Passing through the investigation of disposable syringes use condition, to determine amount of syringes used in the hospital and extent of their contact with blood and body fluids, and to assess their waste polluted condition. METHODS By our hospital computer charge system, from May 1, 2006 to Apr 30, 2007 The used syringes were calculated. RESULTS A total of 923 676 plastic disposable syringes were used; from them 6 801 (0.74%) were contaminated by blood, an other body fluids (urine, gastric secretion, cerebrospinal fluid, and wound drainage) or cells, 16 892 (1.83%) were by anticancer drugs and 160 461(17.37%) were with different injections or contrasts. 739 522(80.06%)were utilized for dilute medicine in i.v. drip. CONCLUSIONS Eighty percent of syringes waste is without pollution, it can be used to regard as recycled resources.

Washing and Sterilization Methods for Endoscopic Cell Brush:A Simulated Experimental Research / 中华医院感染学杂志

OBJECTIVE To explore the efficientcy of washing and sterilization methods for the endoscopic cell brush. METHODS The contaminated cell brush with the mixture of Bacillus subtilis var.niger spore and blood was washed by four methods:manually washing,multienzyme plus manually washing,ultrasonic cleaner washing,and multienzyme plus ultrasonic cleaner washing,and then dipped in glutaraldehyde for 5 h or 10 h,fumigated with glutaraldehyde for 5 h,and sterilized with 3M ethylene oxide box.The positive rates of occult blood test(OB test),the cleaning rates of B.subtilis var.niger spore and the sterilization eligibility ratio of four serilization methods were compared. RESULTS The washing method that multienzyme plus ultrasonic cleaner washing could clear effectively the contaminated cell brush that the positive rates of OB test was 0 and the cleaning rates of B.subtilis var.niger spore was 99.90%.The positive rates of OB test and the cleaning rates of B.subtilis var.niger spore of manually washing was 56.67% and 90.87%.Fumigated in 3M ethylene oxide box or dipped in glutaraldehyde for 10 h could kill all the spores,but dipped in glutaraldehyde for 5 h or fumigated with glutaraldehyde for 5 h could not. CONCLUSIONS The mixed contaminated endoscopic cell brush should be washed effectively by multienzyme+ ultrasonic cleaner washing,and should be sterilized by fumigated in ethylene oxide box or dipped in glutaraldehyde for 10 h.