Objective To summarize the methods and outcome of surgical treatment of thyriod carcinoma(TC).Methods The clinical data of 126 cases of TC admitted between 1990 to 2005 to our 2 hospitals was analyzed.Results Among the 126 cases,there were papillary carcinoma in 94 cases(74.5%),follicular carcinoma in 20 cases(15.9%),medullary carcinoma in 5 cases(4%),anaplastic carcinoma in 4 cases(3.2%),lymphoma in 2 cases(1.6%) and squamous cell carcinoma was in 1 case(0.8%).Thyroid microcarcinoma(TMC) was found in 56 of 126 cases and all of them were papillary carcinoma.(Seventy)-eight cases were followed up for more than 5 years after operation and 36 cases for 3 to 5 years,and all have good quality of life.All of the 4 cases with anaplastic carcinoma died in 3 to 6 months.Two cases with medullary carcinoma and 1 case with squamous cell carcinoma died from pulmonary metastases 1 year after operation.Conclusions For differentiated TC,surgical treatment is the ideal treatment.However,for(anaplastic) TC,operation is not to be recommended,the choice of treatment is radiotherapy.

OBJECTIVETo clone and construct a eukaryotic expression vector of human bone morphogenetic protein (BMP) 2 and histidine in vitro and synthesize chitosan (CS)/pIRES2-EGFP-hBMP2-His nanoparticles.

METHODSpMD18T-hBMP2-His was digested by EcoR I and BamH I to obtain the hBMP2-His gene, which was inserted into pIRES2-EGFP to form pIRES2-EGFP-hBMP2-His. Afterward, CS, which exhibited five different molecular weights and deacetylation degrees, was complexed with pIRES2-EGFP-hBMP2-His to form CS/pIRES2-EGFP-hBMP2-His nanoparticles; in this procedure, a desolvent method was used at different N/P ratios (amino in CS to phospho in plasmid DNA). The gene-encapsulating ability of CS was evaluated by agarose gel electrophoresis and fluorescence spectrophotometry; size, distribution, and potential were analyzed using a ZetaPALS analyzer. The shape of the nanoparticles was observed under an atomic force microscope.

RESULTS1) pIRES2-EGFP-hBMP2-His was constructed after the cloned hBMP2-His gene was confirmed by sequencing. 2) CS/pIRES2-EGFP-hBMP2-His nanoparticles were synthesized and pIRES2-EGFP-hBMP2-His was packaged by CS. 3) CS/pIRES2-EGFP-hBMP2-His nanoparticles were globular with an average size of 111.7 nm to 3,214.2 nm and an average zeta-potential of 4.93 mV to 16.79 mV.

CONCLUSIONCS/pIRES2-EGFP-hBMP2-His nanospheres are successfully synthesized.

Objective To discuss the clinical manifestations,imaging features and prognosis of children with mild encephalitis/encephalopathy with a reversible splenial lesion(MERS).Methods Twenty-five patients with MERS admitted to Beijing Children′s Hospital,Capital Medical University,between November 2013 and March 2016 were enrolled and their clinical and imaging data were retrospectively analyzed.Ages of onset of these 25 cases were from 6 months to 13 years old.Because of different clinical manifestations in different onset ages,these 25 cases were divided into 2 groups:≤6 years old group (20 cases),with the onset age of 6 months to 3 years and 9 months old(average 2 years and 2 months);>6 years old group(5 cases),with the onset age of 9 years 3 months to 13 years old (average 10 years and 10 months).Results Nineteen cases among the 25 patients had infection history before onset,including 10 cases of digestive tract infection(all were ≤6 years old children),9 cases of respiratory tract infection(6 children ≤6 years old and 3 children >6 years old).The main clinical manifestations included convulsion (18/25 cases,72.0%),fever (17/25 cases,68.0%),vomiting (11/25 cases,44.0%),and disturbance of consciousness (11/25 cases,44.0%).The main clinical manifestation of ≤6 years old group was convulsion (18/20 cases,90.0%),while the main clinical manifestations of the>6 years old group were fever(3/5 cases,60.0%),headache and dizziness(2/5 cases,40.0%),and none of the patients in >6 years old group had convulsion.Eight cases had liver function injury,myocardial enzymes increased in 10 cases,and hyponatremia occurred in 9 cases.Magnetic resonance imaging (MRI) showed 21 cases were type Ⅰ MERS(only involving corpus callosum),and 4 cases of type Ⅱ MERS which involved corpus callosum as well as deep brain white matter,subcortical white matter (centrum semiovale).MRI lesions disappeared after 8-56 days (average 16.5 days) of anti-infection and reducing intracranial pressure treatment.Conclusion MERS is more common in ≤6 years old children,and digestive tract infection is common in ≤6 years old children,while respiratory tract infection is common in >6 years old children.The symptoms in children are mainly manifested as fever,convulsion,vomiting,conscious disturbance,and so on.Infection and hyponatremia are the main causes of MERS in children.MRI is the first choice of imaging examination methods.

BACKGROUND: There are various kinds of design methods about preoperative osteotomy of ankylosing spondylitis with kyphosis, but each has their own errors and limitations. A convenient, precise and available method needs to bedeveloped.OBJECTIVE: To compare the clinical efficacy of two different preoperative osteotomy designs using paper-cut andphotoshop software for ankylosing spondylitis with kyphosis.METHODS: Thirty-nine patients suffering ankylosing spondylitis with kyphosis undergoing osteotomy in the Departmentof Spinal Surgery, Affiliated Hospital of Yan'an University between June 2009 and January 2015 were enrolled, andrandomly allotted to paper-cut (n=19) and photoshop (n=20) groups, followed by the preoperative osteotomy design,respectively. All patients were followed for 12-40 months to compare the postoperative osteotomy angle error andcorrection efficacy at the last follow-up between groups.RESULTS AND CONCLUSION: (1) The postoperative osteotomy angle error in the photoshop group was significantly smaller than that in the paper-cut group (P < 0.05). (2) At the last follow-up, the key parameters of sagittal spine and pelvis (sagittal vertical axis, Cobb angle and pelvic tilt) showed significant differences between groups (P < 0.05). (3) The Oswestry disability index and Scoliosis Research Society-22 questionnaire scores in the photoshop group weresignificantly superior to those in the paper-cut group at the last follow-up (P < 0.05), while the visual analog scale scoresdid not differ significantly between groups (P > 0.05). (4) To conclude, compared with the osteotomy design usingtraditional paper-cut splice, the photoshop software can achieve a smaller osteotomy angle error and better postoperative balance of spinal sagittal plane, thus providing precise osteotomy for surgeons to obtain proper correction.

Objective To improve the protocols of red blood cells ( RBCs) processing devices ( automatic medical RBC centrifuge, type:BBS926).Methods RBCs separated from 400 ml of whole blood collected from healthy donors were frozen at -80℃.After thawing , the cells were processed by the washing device .Based on the original protocol ( protocol 1), a modified protocol (protocol 2) was established and used to evaluate the quality of the frozen RBCs .In the test group (protocol 2), the amount of washing buffers and the washing steps were revised to form the optimized protocol .RBCs processed with the two protocols were evaluated by different assays .Results The indexes from the standards for frozen-thawed RBCs: the amount of hemoglobin ( Hb) of RBCs from protocol 1 and protocol 2 was 37.55 ±3.58 and 42.18 ±3.35 g(P<0.05),respectively;the amount of free hemoglobin(FHb) was 0.51 ±0.08 g/L and 0.53 ±0.07 g/L (P>0.05);the residual amount of white blood cells (WBCs) was (1.90 ±0.99) ×107 and (1.92 ±1.04) ×107(P>0.05);The osmolarities were 334 ±8.03 mOsm and 327 ±9.06 mOsm(P>0.05);both the bacteria and fungi tests were negative for the RBCs processed with the two protocols .Among other indexes ,the hemolysis rate for RBCs from protocol 1 and protocol 2 was (12.44 ±8.24)%and (12.02 ±5.78)%(P>0.05), the deformation index was 21.40 ±1.41 and 21.42 ±1.45 (P>0.05), the RBC recovery was(72.02 ±3.70)%and (77.18 ±5.58)%(P<0.05),the cell apopto-sis rate was(1.12 ±0.54)%and (1.10 ±0.61)%(P>0.05),and the processing time was (79.00 ±0.71)min and (79.60 ±0.55)min (P>0.05).Conclusion The RBCs processed by the two protocols meet the national standards for frozen-thaw RBCs.Hb amounts and cell recoveries of the RBCs are enhanced by treatment with protocol 2.Protocol 2 proves to be better than protocol 1.

Objective: To study the hearing status and analyze the related influencing factors in noise-exposed workers in an automobile manufacture enterprise, and put forward suggestions for prevention of noise-induced hearing loss. Methods: Noise exposure level testing, audiometry testing and questionnaires were performed for noise exposed workers in the automobile manufacture enterprise. To analyze the relationship between different factors and noise-induced hearing loss by cumulative noise exposure(CNE) calculated 8-hour continuous A-weighted equivalent noise level and seniority. Results: The detection rate of hearing loss in noise-exposed workers was 22.8%. The noise exposure intensity of stamping workshop is higher than other workshop, and the hearing loss detection rate of stamping workshop workers is higher than other workshop workers. The detection rate of hearing loss has significant difference in L_{Aeq·8 h}, seniority, CNE, age, high temperature and wearing earplugs (P<0.05). The results of logistic regression analysis showed that CNE, age and high-temperature were risk factors for noise-induced hearing loss (P<0.05 and OR>1) and there was an increasing tendency of hearing loss with increase in length of service and CNE, while using of earplugs was a protective factor (P<0.05 and OR<1). With the increase of CNE, the incidence of hearing loss is the rising trend. Conclusion It is suggested to strengthen the noise control and individual protection and improve the high-temperature working environment, which plays an important role in reducing the occurrence of noise-induced hearing loss.

Objective To know the head nurses′ mental health in Huaian tertiary hospitals and researching the effects of working experience, job title and departments on head nurses′mental health, so as to provide references for the interventions. Methods Totally 202 head nurses from 7 tertiary hospitals in Huaian area were selected as the research object. The general questionnaire and the symptom checklist-90 ( SCL-90) were used to conduct the investigation. A total of 202 questionnaires were sent out and 183 valid questionnaires of them were taken back, and the effective rate reached up to 90. 59%. Results Except for the symptoms of terror factor, hostile, the remaining seven symptoms factors, SCL-90 total score and the number of positive items were all significantly higher than the national norm (P<0.01). As the survey results showed, the difference in tenure matron SCL-90 total average score, the score of somatization, depression, coercion, anxiety and interpersonal relationship, paranoia and psychotic average were statistically significant ( P<0.05) . Differences in the scores of depression and paranoid symptoms with different professional titles were statistically significant differences ( P<0. 05 ) . There were statistically significant differences in the scores of somatic, depression, obsessive-compulsive and anxiety symptoms among head nurses in different departments (P<0.05). Statistical index positive rate:head nurses′total SCL-90 score was over 160 points, and accounted for 30.60%;individual positive items were >43, and accounted for 32. 79%; The positive rates of each factor were more than 10%except hostility and terror. Conclusions The mental health situation of head nurses in tertiary hospitals of huaian is not optimistic, and the authorities and the head nurses need to take active interventions to promote their mental health and improve the quality and efficiency of care work.

ObjectiveTo explore the nursing managers' cognition, willingness, pros and cons, and suggestions on nurses' multi-site practice, aiming at providing reference for the policy formulation, implementation and effective management in related institutions. MethodsBased on the phenomenological research method in qualitative research, in-depth interviews were conducted with 10 nursing deans in 10 ClassⅢ hospitals in Jiangsu Province from January to April 2018, and analyzed by Colaizzi analysis program. The nursing managers in Jiangsu Province were investigated in detail about their cognition, willingness, evaluation and suggestions on the pros and cons of nurses' multi-site practice. ResultsThe themes summarized included:"four areas of influences of nurses' multi-site practice on the society, government, hospital, and nurses themselves" "obstacles and difficulties in conducting nurses' multi-site practice" and "suggestions on nurses' multi-site practice". ConclusionsThe nursing managers have a high level of perception towards the nurses' multi-site practice, however, the medical institutions are still at a wait-and-see stage. To prepare for multi-site practice, relevant laws and legislation should be established and regulated as soon as possible, meanwhile, the management ideology and human resources management should be renovated, the admission standards of the qualification of nurses' multi-site practice should be made more strict, and the good conditions for multi-site practice should be created through interdisciplinary cooperation and great efforts.

Objective To clone and construct a eukaryotic expression vector of human bone morphogenetic protein (BMP) 2 and histidine in vitro and synthesize chitosan (CS)/pIRES2-EGFP-hBMP2-His nanoparticles. Methods pMD18T-hBMP2-His was digested by EcoRⅠand BamHⅠto obtain the hBMP2-His gene, which was inserted into pIRES2-EGFP to form pIRES2-EGFP-hBMP2-His. Afterward, CS, which exhibited five different molecular weights and deacetylation degrees, was complexed with pIRES2-EGFP-hBMP2-His to form CS/pIRES2-EGFP-hBMP2-His nanoparticles; in this procedure, a desolvent method was used at different N/P ratios (amino in CS to phospho in plasmid DNA). The gene-encapsulating ability of CS was evaluated by agarose gel electrophoresis and fluorescence spectrophotometry; size, distribution, and potential were analyzed using a ZetaPALS analyzer. The shape of the nanoparticles was observed under an atomic force microscope. Results 1) pIRES2-EGFP-hBMP2-His was constructed after the cloned hBMP2-His gene was confirmed by sequencing. 2) CS/pIRES2-EGFP-hBMP2-His nanoparticles were synthesized and pIRES2-EGFP-hBMP2-His was packaged by CS. 3) CS/pIRES2-EGFP-hBMP2-His nanoparticles were globular with an average size of 111.7 nm to 3 214.2 nm and an average zeta-potential of 4.93 mV to 16.79 mV. Conclusion CS/pIRES2-EGFP-hBMP2-His nanospheres are successfully syn-thesized.

Objective To observe the influence of functional ankle instability(FAI)on balance and lower limb explosive power. Methods A total of 26 male FAI participants,13 bilateral(bilateral group)and 13 left(left group),who regularly en-gaged in high-intensity exercise,were recruited at Harbin Sport University in May,2024.Meanwhile,13 unin-jured male participants who engaged in high-intensity exercise were recruited as control group.They were mea-sured the moving area of the left foot,right foot and body center of gravity standing on feet with the eyes opened and closed;as well as the sway angle,confidence ellipse diameter(maximum and minimum)to circle area ratio,sway ratio and confidence ellipse standing on single foot,with Gaitview plantar pressure analysis system.They were also tested with Y-balance test(YBT),and were measured flight time and center of gravity height during jumps single leg left/right drift,stiffness and counter movement jump using Opto-jump Optical Measurement of Motor Quality. Results There were significant differences among the groups in swing angle,confidence ellipse diameter(maximum and minimum)to circle area ratio,swing ratio and confidence ellipse as left-leg stance with eyes closed(F>3.300,P<0.05),which was the least in the control group(P<0.05).Swing angle,swing ratio and confidence ellipse were also different among the groups as right-leg stance with eyes closed(F>4.404,P<0.05),and they were less in the control group than in the bilateral group(P<0.05),and less in the left group than in the bilateral group(P<0.05),except swing angle.There was a significant difference in YBT results(F>3.649,P<0.05),which was the least in the bilateral group(P<0.05).There were significant differences in the flight time and center of gravity height during counter movement jump(F>7.458,P<0.01),which was the least in the bilateral group(P<0.05). Conclusion FAI may impair the static balance as single-leg stance with eyes closed,dynamic balance and lower limb ex-plosive power.