简介：摘要：目的：甲状腺结节分类诊断过程中采用TI-RADS分类法，观察该种分类方法的应用效果。方法：将我科2018年1月--2020年10月的甲状腺结节297例患者353个结节作为观察对象，并且根据分类方法不同，将患者分成一组和二组，一组使用TI-RADS分类法，二组使用ATA标准分类。结果：（1）本次总共选择353个甲状腺结节作为研究对象，其中良性结节210个，占比59.49%；恶性结节143个，占比40.50%。（2）一组和二组甲状腺结节分类后从NPV、PPV、敏感性、特异性、准确性对照中，一组分别是94.33%、76.20%、88.66%、84.13%、89.23%，二组分别是85.26%、69.68%、77.33%、71.10%、81.01%。（x2=10.021,p=0.000），结果有差异。结论：甲状腺结节诊断过程中采用TI-RADS分类法价值较高，该种方法值得在临床上推广。

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简介：AbstractObjective:To provide an overview of the current available music assessment tools after cochlear implantation (CI); to report on the utilization of music assessments in the literature; to propose potential future directions in music assessment after CI.Methods:A thorough search was performed in PubMed, Embase, and The Cochrane Library through October 31, 2020. MeSH search terms, keywords, and phrases included "cochlear implant," "cochlear prosthesis," "auditory prosthesis," "music," "music assessment," "music questionnaire," "music perception," "music enjoyment, and "music experience." Potentially relevant studies were reviewed for inclusion, with particular focus on assessments developed specifically for the cochlear implant population and intended for widespread use.Results/conclusions:Six hundred and forty-three studies were screened for relevance to assessment of music experience among cochlear implantees. Eighty-one studies ultimately met criteria for inclusion. There are multiple validated tools for assessment of music experience after cochlear implantation, each of which provide slightly differing insights into the patients’ subjective and/or objective post-activation experience. However, no single assessment tool has been adopted into widespread use and thus, much of the literature pertaining to this topic evaluates outcomes non-uniformly, including single-use assessments designed specifically for the study at hand. The lack of a widely accepted universal tool for assessment of music limits our collective understanding the contributory and mitigating factors applicable to current music experience of cochlear implantees, and limits our ability to uniformly evaluate the success of new implant technologies or music training paradigms.

简介：AbstractSevere fever with thrombocytopenia syndrome (SFTS) was first detected in China in 2009. The incidence of SFTS increases year by year, and there is no effective treatment. Considering that the reported prevalence of SFTSV infection varies from region to region, we aimed to quantitatively evaluate the epidemic characteristics of SFTSV infection in China from 2010 to 2020, including the distribution differences in infectious season, sex, age, occupation, and region. A meta-analysis framework was used to search for the related published data with keywords in electronic databases (CNKI, WanFang, CBM, and PubMed). According to the PRISMA statement, the studies that included SFTS diagnosed in China were analyzed. Furthermore, we used Revman and Stata to merge statistical effects, and used I2 and P-values for heterogeneity test and quality assessment. Eleven studies containing 4,932 cases confirmed by SFTSV infection were included in this meta-analysis. The ratio of male-to-female is 1.04 to 1. Cases were concentrated between 40 and 80 years of age (MD = 92%, 95%CI: 91%-93%). Farmers are at the highest risk of SFTSV infection (MD = 84%, 95%CI: 77%-90%). The risk of infection for consecutive period of April-August was significantly higher than the sum of the remaining months (MD = 82%, 95%CI: 78%-85%). In addition, the patient has an extensive history of exposure, including living in the mountains, exposure to ticks, livestock, mouse and the patient. We came to the conclusion that SFTSV is transmitted primarily through tick bites in China, so middle-aged and older adults living in mountains regions are at the highest risk for SFTSV infection in April through August each year.

简介：AbstractBackground:Thyroid dysfunction is associated with cardiovascular diseases. However, the role of thyroid function in lipid metabolism remains partly unknown. The present study aimed to investigate the causal association between thyroid function and serum lipid metabolism via a genetic analysis termed Mendelian randomization (MR).Methods:The MR approach uses a genetic variant as the instrumental variable in epidemiological studies to mimic a randomized controlled trial. A two-sample MR was performed to assess the causal association, using summary statistics from the Atrial Fibrillation Genetics Consortium (n = 537,409) and the Global Lipids Genetics Consortium (n = 188,577). The clinical measures of thyroid function include thyrotropin (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) levels, FT3:FT4 ratio and concentration of thyroid peroxidase antibodies (TPOAb). The serum lipid metabolism traits include total cholesterol (TC) and triglycerides, high-density lipoprotein, and low-density lipoprotein (LDL) levels. The MR estimate and MR inverse variance-weighted method were used to assess the association between thyroid function and serum lipid metabolism.Results:The results demonstrated that increased TSH levels were significantly associated with higher TC (β = 0.052, P = 0.002) and LDL (β = 0.041, P = 0.018) levels. In addition, the FT3:FT4 ratio was significantly associated with TC (β = 0.240, P = 0.033) and LDL (β = 0.025, P = 0.027) levels. However, no significant differences were observed between genetically predicted FT4 and TPOAb and serum lipids.Conclusion:Taken together, the results of the present study suggest an association between thyroid function and serum lipid metabolism, highlighting the importance of the pituitary-thyroid-cardiac axis in dyslipidemia susceptibility.

简介：摘要：社会发展至今，人们的生活质量在不断提高，生活方式也多种多样，但是人一生中有三分之一的时间被草草对待，那就是属于睡眠的时间。睡眠对于人的健康、工作及生活状态都至关重要。

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简介：AbstractBackground:Computed tomography images are easy to misjudge because of their complexity, especially images of solitary pulmonary nodules, of which diagnosis as benign or malignant is extremely important in lung cancer treatment. Therefore, there is an urgent need for a more effective strategy in lung cancer diagnosis. In our study, we aimed to externally validate and revise the Mayo model, and a new model was established.Methods:A total of 1450 patients from three centers with solitary pulmonary nodules who underwent surgery were included in the study and were divided into training, internal validation, and external validation sets (n = 849, 365, and 236, respectively). External verification and recalibration of the Mayo model and establishment of new logistic regression model were performed on the training set. Overall performance of each model was evaluated using area under receiver operating characteristic curve (AUC). Finally, the model validation was completed on the validation data set.Results:The AUC of the Mayo model on the training set was 0.653 (95% confidence interval [CI]: 0.613-0.694). After re-estimation of the coefficients of all covariates included in the original Mayo model, the revised Mayo model achieved an AUC of 0.671 (95% CI: 0.635-0.706). We then developed a new model that achieved a higher AUC of 0.891 (95% CI: 0.865-0.917). It had an AUC of 0.888 (95% CI: 0.842-0.934) on the internal validation set, which was significantly higher than that of the revised Mayo model (AUC: 0.577, 95% CI: 0.509-0.646) and the Mayo model (AUC: 0.609, 95% CI, 0.544-0.675) (P < 0.001). The AUC of the new model was 0.876 (95% CI: 0.831-0.920) on the external verification set, which was higher than the corresponding value of the Mayo model (AUC: 0.705, 95% CI: 0.639-0.772) and revised Mayo model (AUC: 0.706, 95% CI: 0.640-0.772) (P < 0.001). Then the prediction model was presented as a nomogram, which is easier to generalize.Conclusions:After external verification and recalibration of the Mayo model, the results show that they are not suitable for the prediction of malignant pulmonary nodules in the Chinese population. Therefore, a new model was established by a backward stepwise process. The new model was constructed to rapidly discriminate benign from malignant pulmonary nodules, which could achieve accurate diagnosis of potential patients with lung cancer.

简介：摘要内耳畸形（inner ear malformation，IEM）包括膜迷路畸形和骨迷路畸形，临床上，内耳畸形特指可通过影像学观察的骨迷路畸形。内耳畸形分类由早些年基于影像和胚胎的分类方法不断完善，进展到近年来基于指导人工耳蜗手术的分类方法。本文对各种内耳畸形的分类进行系统阐述，重点关注不同分类方法间的差异，探究内耳畸形分类方法更新的意义以及与人工耳蜗手术和预后的关系。

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简介：摘要：目的：探究指针疗法在急诊急救中的应用。方法：研究2020.8—2021.9期间我急救中心转运救治的急诊患者66例，随机分为两组，观察组（33例）和参照组（33例），将指针疗法应用在观察组急诊患者的治疗中，将常规药物治疗应用在参照组急诊患者的治疗中，观察和比较两组治疗效果、并发症发生率。结果：观察组的治疗有效率（93.94%）相比参照组的（75.76%）要更高，并发症发生率（3.03%）相比参照组的（21.21%）要更低，P

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简介：【摘要】: 医院的营销策略对医院的发展起到十分关键的作用，在经济飞速发展的今天，医院营销水平需不断提高才能跟上时代发展的步伐，由于当下医院在市场上的竞争中愈演愈烈，故针对医院所采取的营销方式需结合市场的竞争方向才更为合理。随着微信平台的普及，微信公众号的广泛应用，将其作为一种营销手段应用于医院营销中，故本文针对微信公众号营销应用于医院营销中的策略进行分析讨论。

简介：【摘要】目的：研究院前急救护理路径在急性心肌梗死患者院前救治中的应用效果。方法：将我急救中心2018年10月-2020年10月70例急性心肌梗死患者分为对照组与观察组，各35例。对照组给予基础院前急救护理，观察组给予院前急救护理路径。统计患者的静脉开放用时、急诊停留用时、首次球囊扩张用时、住院时长、不良心脏事件以及患者或家属的护理满意度。结果：相比于观察组，对照组患者的静脉开放用时、急诊停留用时、首次球囊扩张用时、住院时长，均明显更长，两组间的数据差异具有统计学意义（P＜0.05）。对照组患者的不良心脏事件发生率高达28.57%，大幅高于观察组患者的8.57%（P＜0.05）。对照组患者或家属的护理满意度仅68.57%，而观察组患者高达88.57%（P＜0.05）。结论：院前急救护理路径应用于急性心肌梗死患者的临床效果确切，不仅能显著缩短患者的急诊停留用时，且不良心脏事件发生率更低，患者或家属的护理满意度更高。

简介：摘要：目的 探讨在院前救护中如何做好锐器伤的防护工作。方法 利用回顾分析法，以2019年6月~2021年5月咸阳机场医疗急救科院前急救的350例患者为对象，分析急救运送途中可能发生锐器伤的危险因素和采取的相应防护措施。结果 发生锐器伤4例，发生率1.14%。讨论 院前救护中通过加强护理人员自我防护意识，加强、规范护理人员的护理工作行为并采取有效的防护措施是必要的，从而也保障了医护的身心健康。