Thyroid 4a is the ultrasound classification of thyroid nodules, whether it is important or not, mainly combined with the puncture examination to determine; puncture results for benign lesions is relatively does not matter, can be rechecked; puncture results for malignant lesions is a critical situation, need to be treated as soon as possible. 1. If the pathologic result of puncture biopsy shows benign lesion, which is not serious, there is no need to intervene for a short period of time, and regular ultrasound review will be conducted to observe the specific changes of the lesion. 2. Malignant lesions shown by puncture biopsy are more serious and require early surgical treatment under the guidance of a doctor in order to avoid progression of the lesion. Thyroid 4a nodule specific treatment plan, but also combined with other laboratory tests to determine the synthesis, need to be under the guidance of clinicians for standardized treatment.