Objective To investigate the surgical techniques and clinical effect of laparoscopic improved myomectomy. Methods After the surgical techniques and instruments were improved, laparoscopic myomectomies were performed in 91 patients with uterine myoma. The maximum diameter of myoma was (60 4?11 9) mm (range, 25 mm～110 mm), and in 35 cases the myomas were ≥7 0 cm and in 56 cases 0 05). Conclusions After the surgical techniques and instruments were improved, the operation time and the blood loss can be reduced, and better clinical effect obtained, even in patients with somewhat larger uterine myoma.

Objective To investigate the surgical indications and techniques of laparoscopic operations for benign ovarian cysts. Methods A total of 112 patients underwent laparoscopic operations of cyst decollement, ovariotomy and adnexectomy. Results There were 104 cases (92 9%) of decollement, 5 cases (4 5%) of adnexectomy and 3 cases (2 7%) of ovariotomy.The operation time was (61 9?23 7) min, the intraoperative blood loss (37 0?40 7) ml, the postoperative hospital stay (6 8?2 4) days, the postoperative peak temperature of patients (37 8?0 5)℃, the duration of postoperative temperature beyond 37 5℃ (2 0?1 1) days and the time to first passing flatus (1 9?0 5) days. Pathological diagnoses showed 54 cases (48 2%) of ovary endometrial cyst, 30 (26 8%) of benign teratoma, 16 (14 3%) of mesonephroma, 8 (7 1%) of corpus luteum cyst, 3 (2 7%) of serous tumor and 1 (0 9%) fibroma. Conclusions Laparoscopic operations for benign ovarian cysts have advantages of minimally invasive surgery. However, indications must be strictly followed before operations, in the view of avoiding meeting malignant tumors in operations.

Objective To learn the medical experience of inpatients at public hospitals in Henan and the influencing factors.Methods Inpatient experience questionnaire (IPEQ) was customized for a random sampling of 500 inpatients at five tertiary public hospitals in Henan.Results Overall satisfaction of inpatients experience scored 8.48,of which the satisfaction for technical competence was the highest (4.19)and that for emotional support the lowest(3.31).The correlation analysis revealed that the doctors' technical competence score the highest correlation with the experiences (0.652).Conclusion Overall satisfaction of inpatients experience at public hospitals in Henan was found high in general,but humanistic care and service flow at the hospitals require further improvement.

Objective: To investigate the current status of job stress in locomotive attendants in a locomotive depot and related influencing factors. Methods: From 2012 to 2013, cluster sampling was used to select 1500 locomotive attendants in a locomotive depot in Zhengzhou Railway Bureau as respondents.The contents of the investigation included general data and occupational information.A job satisfaction questionnaire was used to investigate the degree of satisfaction, a depression scale was used to investigate the frequency of symptoms, and a daily stress scale was used to investigate the frequency of fatigue and stress. Results: There was a significant difference in depression score between locomotive attendants with different ages, working years, degrees of education, working situations of spouse, total monthly family incomes, numbers of times of attendanceat night, monthly numbers of times of attendance,ormonthly attendance times(P<0.05). There was a significant difference in job satisfaction score between locomotive attendants with different ages,working years, degrees of education, working situations of spouse, total monthly family incomes, numbers of times of attendance at night, monthly attendance times,or ways to work(P<0.05). There was a significant difference in daily stress score between locomotive attendants with different ages, working years, marital status,working situations of spouse, total monthly family incomes, types of work,numbers of times of attendance at night,monthly attendance times,attendance times at night,or ways to work(P<0.05). The multiple stepwise regression analysis showed that the type of locomotive was positively correlated with job satisfaction(β=1.546)and monthly number of times of attendance,working years,attendance time at night,and degree of education were negatively correlated with job satisfaction(β=-0.185,-0.097,-0.020,and -1.106); monthly number of times of attendance andcommute time were positively correlated with depression(β=0.243 and 0.029); attendance time at night,working situation of spouse,commute time,monthly number of times of attendance,degree of education,and working years were positively correlated with daily stress(β=0.006,0.473,0.010,0.043,0.585, and 0.028). Conclusion Number of times of attendance, attendance time,working years,and spouse are influencing factors for job stress in locomotive attendants. Improvement in work process and care for their personal life help to reduce the level of job stress.

Objective:To develop a robotic digestive endoscope system (RDES) and to evaluate its feasibility, safety and control performance by experiments.Methods:The RDES was designed based on the master-slave control system, which consisted of 3 parts: the integrated endoscope, including a knob and button robotic control system integrated with a gastroscope; the robotic mechanical arm system, including the base and arm, as well as the endoscopic advance-retreat control device (force-feedback function was designed) and the endoscopic axial rotation control device; the control console, including a master manipulator and an image monitor. The operator sit far away from the endoscope and controlled the master manipulator to bend the end of the endoscope and to control advance, retract and rotation of the endoscope. The air supply, water supply, suction, figure fixing and motion scaling switching was realized by pressing buttons on the master manipulator. In the endoscopy experiments performed on live pigs, 5 physicians each were in the beginner and advanced groups. Each operator operated RDES and traditional endoscope (2 weeks interval) to perform porcine gastroscopy 6 times, comparing the examination time. In the experiment of endoscopic circle drawing on the inner wall of the simulated stomach model, each operator in the two groups operated RDES 1∶1 motion scaling, 5∶1 motion scaling and ordinary endoscope to complete endoscopic circle drawing 6 times, comparing the completion time, accuracy (i.e. trajectory deviation) and workload.Results:RDES was operated normally with good force feedback function. All porcine in vivo gastroscopies were successful, without mucosal injury, bleeding or perforation. In beginner and advanced groups, the examination time of both RDES and ordinary endoscopy tended to decrease as the number of operations increased, but the decrease in time was greater for operating RDES than for operating ordinary endoscope (beginner group P=0.033; advanced group P=0.023). In the beginner group, the operators operating RDES with 1∶1 motion scaling or 5∶1 motion scaling to complete endoscopic circle drawing had shorter completion time [1.68 (1.40, 2.17) min, 1.73 (1.47, 2.37) min VS 4.13 (2.27, 5.16) min, H=32.506, P<0.001], better trajectory deviation (0.50±0.11 mm, 0.46±0.11 mm VS 0.82±0.26 mm, F=38.999, P<0.001], and less workload [42.00 (30.00, 50.33) points, 43.33 (35.33, 54.00) points VS 52.67 (48.67, 63.33) points, H=20.056, P<0.001] than operating ordinary endoscope. In the advanced group, the operators operating RDES with 1∶1 or 5∶1 motion scaling to complete endoscopic circle drawing had longer completion time than operating ordinary endoscope [1.72 (1.37, 2.53) min, 1.57 (1.25, 2.58) min VS 1.15 (0.86, 1.58) min, H=13.233, P=0.001], but trajectory deviation [0.47 (0.13, 0.57) mm, 0.44 (0.39, 0.58) mm VS 0.52 (0.42, 0.59) mm, H=3.202, P=0.202] and workload (44.62±21.77 points, 41.24±12.57 points VS 44.71±17.92 points, F=0.369, P=0.693) were not different from those of the ordinary endoscope. Conclusion:The RDES enables remote control, greatly reducing the endoscopists' workload. Additionally, it gives full play to the cooperative motion function of the large and small endoscopic knobs, making the control more flexible. Finally, it increases motion scaling switching function to make the control of endoscope more flexible and more accurate. It is also easy for beginners to learn and master, and can shorten the training period. So it can provide the possibility of remote endoscopic control and fully automated robotic endoscope.

Glycoside compounds are widely used in medicine, food, surfactant, and cosmetics. The glycosidase-catalyzed synthesis of glycoside can be operated at mild reaction conditions with low material cost. The glycosidase-catalyzed processes include reverse hydrolysis and transglycosylation, appropriately reducing the water activity in both processes may effectively improve the catalytic efficiency of glucosidase. However, glucosidase is prone to be deactivated at low water activity. Thus, glucosidase was immobilized to maintain its activity in the low water activity environment, and even in neat organic solvent system. This article summarizes the advances in glycosidase immobilization in the past 30 years, including single or comprehensive immobilization techniques, and immobilization techniques combined with genetic engineering, with the aim to provide a reference for the synthesis of glycosides using immobilized glycosidases.
Catalysis ; Enzymes, Immobilized ; Glycoside Hydrolases/genetics* ; Glycosides/biosynthesis* ; Hydrolysis