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Objective:To investigate the application value of contrast-enhanced ultrasound (CEUS) before and after microwave ablation of thyroid nodules.Methods:Fifty-six patients (79 thyroid nodules) who received microwave ablation of thyroid nodules in Huaian Medical District, General Hospital of Eastern Theater Command from March 2016 to October 2019 were included in this study. CEUS was performed before microwave ablation to accurately assess the size, number and blood supply of thyroid nodules as well as the position of the feeding vessels. CEUS was performed immediately after microwave ablation to determine whether the lesion area was thoroughly ablated and to measure the volume of thyroid nodules. At 1, 3, 6 and 12 months after surgery, the level of thyroid hormone was measured and the absorption of thyroid nodules was evaluated.Results:Preoperative CEUS showed that among the 79 thyroid nodules, 42 were solid nodules that had different degrees of enhancement, including 33 annular homogeneously highly enhanced nodules and 9 heterogeneously highly enhanced nodules; 24 were cystic mixed solid nodules that had solid components, including 16 homogeneously highly enhanced nodules and 8 nodules with only local high enhancement in the solid component; 13 were cystic nodules, including 9 nodules with septa and 3 nodules with contrast medium on the diaphragm. Contrast medium was still visible around three nodules immediately after microwave ablation. Ablation continued in three nodules until there was no contrast medium. The incidence of complications during and after treatment was 0%. The average volume of the thyroid nodules before treatment was (7.52 ± 6.74) cm3. At 1, 3, 6 and 12 months after surgery, the average volume of the thyroid nodules was (6.06 ± 5.19) cm3, (3.06 ± 2.85) cm3, (1.32 ± 1.23) cm3 and (0.59 ± 0.52) cm 3, respectively. There was significant difference in volume of thyroid nodules between before and after microwave ablation ( F = 96.32, P < 0.001). Conclusion:Preoperative CEUS can determine the distribution of the blood supply of thyroid nodules and the course of the feeding vessels, identify the needle-entering position for microwave ablation and the primary ablation area, improve the accuracy of treatment, and reduce the occurrence of complications such as bleeding. Postoperative CEUS can determine whether lesion area is thoroughly ablated, reduce residual lesions and excessive ablation.
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Objective To explore the effect of preoperative simulation training on surgical indicators and postoperative infection in patients with intestinal obstruction. Methods From November 2015 to November 2016, 66 patients with intestinal obstruction who received routine nursing in the Second People's Hospital of Wuxi were selected as control group. From December 2016 to December 2017,66 patients with intestinal obstruction surgery who received preoperative simulation training in our hospital were selected. as observation group. The surgical indicators and postoperative infections were compared between the two groups. Results The incision pain time,first exhaust time,land time and the hospitalization time in the observation group were (2. 19 ± 1. 08) d,(1. 53 ± 0. 72) d, (5. 21 ± 0. 98)d,(9. 75 ± 1. 49)d,respectively,which were shorter than those in the control group (all P < 0. 05). The CRP levels at postoperative 1 d,3 d and 6 d in the observation group were (6. 36 ± 1. 57) mg/ L,(7. 36 ± 1. 21)mg/ L,(6. 38 ± 1. 19)mg/ L,respectively,the PCT levels were (0. 46 ± 0. 14)ng/ mL,(0. 60 ± 0. 11)ng/ mL, (0. 38 ± 0. 06) ng/ mL, respectively, which were all lower than those in the control group, the differences were statistically significant ( all P < 0. 05). Conclusion Preoperative simulation training for patients with intestinal obstruction surgery can effectively optimize the surgical indicators and improve postoperative infection,and it is worthy of popularizing and applying.
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Objective To analyze the clinical value of low molecular heparin calcium combined with early rehabilitation intervention in the prevention of deep vein thrombosis after internal fixation of intertrochanteric fractures.Methods 100 patients with internal fixation for treatment of femoral intertrochanteric fracture from January 2014 and October 2015 were selected and randomly divided into two groups:the control group of 50 cases, treated with low molecular weight heparin low molecular weight heparin by abdominal subcutaneous injection of drug therapy and routine nursing intervention service, observation group of 50 cases, in the control group based on the use of early rehabilitation intervention.The incidence of deep venous thrombosis after operation in two groups was recorded, and the changes of platelet count and coagulation markers were observed before and after intervention in the two groups.Results The observation group of patients with postoperative deep venous thrombosis incidence rate of 4%, significantly lower than the control group 16%, the difference was statistically significant (P<0.05), the two groups after the intervention each time the platelet count was higher than that of before intervention, four weeks after the intervention, the observation group of platelet count (239.51 ±34.62) ×109/L, significantly higher than the control group (235.23 ±28.87) ×109/L, the difference was statistically significant (P<0.05), the two groups before the intervention of each marker concentration, the difference was not statistically significant, patients in the observation group after the intervention, the blood coagulation markers concentrations were significantly lower than before treatment, and were significantly lower than the control group after the intervention.The comparison between the two groups, the difference was statistically significant (P<0.05).There was no chest pain, chest tightness, dyspnea and other symptoms of pulmonary embolism in the two groups , and no adverse reactions were found.Conclusion The application of low molecular weight heparin calcium combined with early rehabilitation intervention can effectively reduce the incidence of deep venous thrombosis after intertrochanteric fracture fixation.
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Objective To study the effect of compound hypertonic saline solution (HSD) on sepsis.Methods 133 male Wistar rats were divided into four groups,sham operation group (n =15),cecal ligation and puncture (CLP)group (n =45),CLP plus normal saline (NS) group (n =45),and CLP plus HSD group (n =28).A rat model of sepsis was reproduced by CLP,and the rats in sham operation group received celiotomy without ligation and puncture.All rats in four groups received subcutaneous injection of 30 mL/kg 0.9％ sodium chloride after laparotomy.The rats in CLP plus NS group and CLP plus HSD group received infusion of 5 mL/kg 0.9％ sodium chloride or 7.5％ sodium chloride/6％ dextran post CLP via jugular vein for 3 hours,with the infusion rate of 0.4 mL·kg-1·min-1.The survival rate of each group was observed 9 hours and 18 hours after laparotomy.Mean arterial pressure (MAP) at 0,9,18 hours were monitored.Blood specimens were collected from all rats 0,9 and 18 hours after laparotomy,respectively,for measurement of the plasma levels of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β),and procalcitonin (PCT).The rats were all sacrificed,and their lung tissues were harvested for the neutrophil count in bronchoalveolar lavage fluid (BALF),myeloperoxidase (MPO) activity in lung tissue,wet/dry weight ratio (W/D) of lung,and pathological changes in lung tissue.Results There was no death in the sham operation group.The survival rates at 9 hours and 18 hours were 62.2％ and 31.1％ in the CLP group,57.8％ and 35.6％ in the CLP plus NS group,85.7％ and 64.3％ in the CLP plus HSD group,and they were all significantly higher compared with those of the CLP group and the CLP plus NS group (P ＜ 0.05 or P ＜ 0.01).MAP levels in the CLP group and the CLP plus NS group were significantly lower than those in sham operation group,and the plasma levels of TNF-α,IL-1β and PCT were significantly higher compared with those of sham operation group,while there was no difference between CLP group and the CLP plus NS group.MAP and the plasma levels of TNF-α,IL-1β and PCT in the CLP plus HSD group were significantly improved compared with those of the CLP plus NS group at 9 hours and 18 hours [MAP (mmHg,1 mmHg =0.133 kPa) at 9 hours:102±5 vs.94±6,18 hours:90±2 vs.72±3; TNF-α (ng/L) at 9 hours:284.19±57.18 vs.329.67±45.79,18 hours:263.46±42.58 vs.349.68±52.40; IL-1β (ng/L) at 9 hours:219.28±39.21 vs.263.47±32.36,18 hours:195.98±39.06 vs.250.10±41.57; PCT (μg/L) at 9 hours:2.32±0.37 vs.4.52±0.75,18 hours:2.89±0.62 vs.5.02±0.84; P ＜ 0.05 or P ＜ 0.01].The ratio of neutrophils in BALF,MPO activity and lung W/D at 18 hours in the CLP group and the CLP plus NS group were significantly higher than those of the sham operation group,while they were all significantly lower in the CLP plus HSD group than those of the CLP group and the CLP plus NS group [ratio of neutrophils in BALF:0.094±0.019 vs.0.148±0.062,0.151 ±0.055; MPO (U/g):1.19±0.45 vs.2.31 ±0.79,2.64±0.69; lung W/D ratio:4.02 ± 0.63 vs.5.14 ± 0.59,5.12 ± 0.83,all P ＜ 0.05].Under light microscope,no pathobiological changes were found in sham operation group.The lung tissues in the CLP group and the CLP plus NS group showed congestion,edema,infiltrating inflammatory changes,while the inflammatory changes in the lung tissue in the CLP plus HSD group were significantly alleviated.Conclusion HSD can obviously ameliorate the circulatory failure in septic rats,alleviate immune disturbance and acute lung injury,and improve the survival rate of rats with sepsis.
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Objective To investigate the clinical significance of the serum levels of sICAM-1,ET,MCP-1 and APN in patients with acute cerebral infarction(ACI).Methods 120 patients with ACI were selected and divided into different groups according to the size of infarction and clinical neurologic impairment degree score.The serum levels of sICAM-1,ET,MCP-1 and APN were detected by enzyme-linked immunosorbent assay.A healthy control group which approximately matched the experimental group included 30 persons.Results The serum sICAM-1,ET and MCP-1 levels in the patients with ACI were significantly higher than those in the healthy groups (all P ＜ 0.05).The serum levels of sICAM-1,ET and MCP-1 were increased steply with the volume of infarction and the clinical neurologic impairment degree score,the differences between the groups was significant (all P ＜ 0.05).The serum APN levels.In the patients with ACI were significantly lower than that in the healthy groups (P ＜ 0.05).The serum levels of APN were decreased steply with the volume of infarction and the clinical neurologic impairment degree score,the differences between the groups were significant (all P ＜ 0.05).Conclusion The sICAM-1,ET,MCP-1 and APN may play an important role in the pathogenesis of ACI.The serum levels of sICAM-1,ET,MCP-1 and APN are closely correlated with the clinical neurologic impairment degree score and the volume of infarction,which may be of great value in predicting acute cerebral infarction and the severity of cerebral infarction.
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According to the principles of constructing evaluation index system in designed experiments,we formulated the content,designed the weights and established the evaluation index system in designed experiments based on analytical hierarchy process and Delphi.This system can assess students' cognition and attitudes,abilities of innovation,practice,teamwork and cooperation as well as scientific writing skills by providing objective and comprehensive evaluation criteria.
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Objective To study the angiographie characteristics of coronary heart disease (CHD) patients with type 2 diabetes mellitus.Methods 292 patients with CHD underwent a selective angiography were selected,the characteristics of coronary arteriongraphy were compared in CHD patients with type 2 diabetes mellitus and nondiabetic group.Results In type 2 diabetes mellitus group,the degree of stenosis was higher than that in nondiabetic group (78.01% vs 52.32% )(P < 0.05 ), and the rate of three-vessel disease was higher than that in nondiabetic group (59.57% vs 36.42% )(P <0.05).Conclusion The angiographic characteristics were different in CHD patients with or without type 2 diabetes mellitus.Patients with type 2 diabetes mellitus was associated with more severity of lesion and more lesion vessel.
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Objective To explore the correlation between obstructive sleep apnea syndrome(OSAS)and developing hypertension.Methods Clinical data of 124 OSAS patieats with high blood pressure were retrospectirely,and according to the degree of hypoxemia they weredivided into three groups,monitoring of the night and 7h polysomnography figure,compare each group,woke up blood pressure changes before bedtime.Results 124 patients with hypertension OSAS clinical manifestation:snoring 124 cases(100.0％),daytime sleepiness 74 cases(59.7％),wake up in the night to suppress 49 cases(39.5％),night apnea 39 cases(31.5％),woke up oppressed 26 patients (21.0％),since morning headache 19 patients(15.3％).OSAS merger hypertension,light,medium,heavy hypoxemia between groups of blood pressure,blood pressure after come before a statistically significant difference(P ＞0.05).Conclusion Hypoxia was associated with high blood pressure.
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Since the attenuated live vaccine against measles was developed,the epidemic of measles has been controlled effectively,however,there is a trend of gradual increase of measles cases in recent years.The epidemiological and clinical features of 4430 measles patients in Shenzhen Municipality in last 10 years were reviewed.The data showed that the epidemic season was postponed with the peak of June to September;the prevalent age groups were infants and adults,the number of severe cases increased;and the positive rate of serological antibody in infants with measles was the lowest.
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Telomerase activity was examined in invasive cervical carcinoma to assess whether it is activated during cervical malignant transformation and to look for its possible association with human papillomavirus (HPV) infection. Histologically confirmed invasive cervical carcinomas and benign cervices were assayed for telomerase activity by using a modified telomere repeat amplification protocol (TRAP). The same cases were subjected to polymerase chain reaction (PCR) detection of HPV by using consensus primers and type-specific (HPV types 16 and 18) primers. Telomerase activity was detected in 40 of 45 (88.9%) invasive cervical carcinomas and 2 (all chronic cervicitis) of 50 (4%) benign cervical lesions. HPV was detected in 36 (24 HPV-16 and 4 HPV-18 cases) of 45 (80%) invasive cervical carcinomas and 20 (11 HPV-16 and 1 HPV-18 cases) of 50 (40%) benign cervical changes. There was a significant correlation between the expression of telomerase with histological grade (φ=0.44, P＜0.005), but no correlation was found between telomerase expression and HPV-18 (P＞0.05). Although larger sample studies are needed, there seems to be a clear association between telomerase upregulation and HPV status, mainly HPV-16 infection.
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This paper discusses application of multimedia and network technology in Laboratory Animal Science Teaching:We have set up multimedia courseware,made animal experiment video and built network course-learning system and a good teaching effect has been achieved.Then it analyzes the problems of multimedia and network technology in Laboratory Animal Science Teaching.
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Objective To explore the clinical value of laparoscopic-assisted vaginal hysterectomy(LAVH)in large uterus.Methods Retrospective analysis was conducted on clinical data of 94 patients(whose uterus were as big as 10-18 gestational weeks)who received hysterectomy from January 2005 to March 2007,in which 56 cases were performed laparoscopic-assisted vaginal hysterectomy(LAVH group)and 38 cases vaginal hysterectomy(VH group).The operation time,blood loss,postoperative hospital stay,and the incidence of postoperative complications were compared between the two groups.Results Compared with VH group,there were a lower chance of abdominal hysterectomy(0/56 vs 5/38,?2=5.389,P=0.020),a shorter operation time [(149?11)min vs(179?14)min,t=-11.610,P=0.000] and a shorter postoperative hospital stay [(5.8?1.4)d vs(7.3?3.6)d,t=-2.825,P=0.006] in the LAVH group.There were no significant differences in blood loss,morbidity and time to first flatus between the two groups.Conclusions The LAVH extends the indications of VH,ensuring the safety of VH for the uterus bigger than 10 gestational weeks,therefore it is an operative procedure to be recommended.
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The enrollment physical examination,as a real assessment of the physical and health condition for those high school graduates,is of great referencing significance for their major selection.Therefore,during the examination process,medical staff involved should enhance their recognition for relevant legal regulations,and fully respect graduates′ rights of privacy and informed consent,to ensure the impartiality,fairness,reality,and effectiveness of the assessment result,and guarantee the legal rights of high school graduates.
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The old clinical teaching pattern seems less complied to the current condition,due to its specific features problems in the clinical teaching of gynecology seem more significant.Therefore,it is of great importance to apply advanced technology to improve teaching methods,stress medical ethics education,and safeguard the patients′ legal rights of informed consent and privacy.
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Extraction of teeth is the most basic and widely used operation of oral and maxillofacial surgery. According to characteristics of extraction of teeth, the author views medical ethics principles which in the diagnoses and treatments process from the aspect of medical ethics, they are,①Doctors must intensify their own quality and self - cultivations and establish the idea of " People First ". ②Doctors must carry on the overall and systematic inspection, make the plan of diagnoses and treatments synthetically toimplement the idea of " People First ". ③Doctors should pay attention to interact with patient, meet different patients' demands and create the harmonious medical environment.
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Objective To explore the effect of nerve growth factor(NGF) in the lower respiratory tract and the visceral afferent system of asthmatic guinea pigs. Methods By means of immunohistochemistry and in situ hybridization combined with the micro-image analysis to investigate the alterations of NGF immunoreactivity and mRNA expression in asthmatic guinea pig. Results The positive NGF immunoreactivity was increased in airway epithelia,C-7-T-5 spinal ganglia and correspondent spinal dorsal horn in the asthmatic guinea pigs compared with the controls(P