Objective To improve the recognition, diagnosis and treatment of synchronous bilateral thyroid carcinoma(SBTC). Methods The diagnosis and treatment of 11 patients with SBTC were analysed. Results Of them, 9 patients were well differentiated cancer, 1 medullary cancer, 1undifferentiated cancer. The diagnosis was comfirmed by needle aspiration biopsy(NAB) in 2 cases preoperatively, by frozen section in 4 cases intraoperatively. Among the 11 patients, total thyroidectomy was performed on 4 patients, near total thyroidectomy on 7 patients; functional neck dissection(FND) on 7 patients. Ten patients were followed up for 1～2 years (average 4 years and 9 months), only 1 patient died; 9 patients were alive and 8 were free of cancer. Conclusions The diagnosis of SBTC is difficult before operation, so for suspicions patient of SBTC, preoperative NAB or intraoperative frozen section should be done to make the diagnosis. The choice of surgery for SBTC is near total thyroidectomy. FND should be done, if the patient has indication of FND, but a preventing FND is not advocated.

Objective To understand the relationship among nurses′ emotional labor, workgroup emotional climate and mental health. Methods Cluster sampling was used to pick up 250 samples, which consisted of nurses from a 3-A-grade hospital in Nanjing-the Second Affiliated Hospital of Nanjing Medical University. Self-designed general questionnaires, Emotional Labor Scale (ELS), Workgroup Emotional Climate Scale (WECS), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were administrated to the study participants. Results The scores of nurses′emotional labor among three dimensions were in descending order: deep acting (5.16 ± 1.30), emotional display requirement (3.54 ± 0.57) and surface acting (3.35 ± 0.1). Nurse′s surface acting was negatively related to other-focused positive WEC (OP) and ego-focused positive WEC (EP) (r=-0.162,-0.154, P < 0.05), while positively related to ego-focused negative WEC (EN) and other-focused negative WEC (ON) (r=0.358, 0.176, P <0.01), Emotional display requirement was negatively related to ego-focused negative WEC (EN) and other-focused negative WEC (ON) (r=-0.239,-0.269, P < 0.01), and was positively related to other-focused positive WEC (OP) and ego-focused positive WEC (EP) (r=0.276, 0.339, P<0.01);nurses′anxiety score=35.502+1.203 × EN-0.496 × deep acting+0.27 × surface acting;nurses′depression score=53.438+1.259 × EN-1.115 × OP. Conclusions Nurse managers must know that constructing high qualitydepartment emotional culture is very important. Nursing managers discover individual negative emotions, improve their ability to control the mood and reduce the number of surface acting, increase the number of deep acting, in order to effectively change nurses′anxiety and depression levels.

Objective To investigate the life quality of parents of asthma children as well as the influencing factors? Method Totally 125 parents of children with asthma from three different communities in Guangzhou were involved in the survey by the Chinese Paediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) and demographic questionnaire? Results The total score on PACQLQ was(4?34±1?03): the scores on dimentions of limited motion and affection were(4?29±1?55)and(4?36±0?89),respectively?The major factors influencing the life quality of their parents included the relationship with them and their disease course? Conclusions The life quality of their parents reaches the lowest level at the beginning of confirmed diagnosis of asthma? The health education should be performed right after confirmed diagnosis? During health education,their mental stress is worth our great attention?

Objective To explore the influence of individualized health education to asthma children on the quality of life of their parents.Methods One hundred and one parents of asthmatic children from 3 different communities were randomly assigned to the intervention group(n=52)and the control group(n=49).Follow-ups were performed by phone calls and the Children Asthma Health Education Brochures were distributed among them in the two groups,meanwhile the individualized health education was given to the intervention group.The paediatric asthma caregiver's quality of life questionnaire(PACQLQ)was used to assess the quality of life of two groups.Results One month after intervention,the scores of the intervention group on PACQLQ total score as well as its items of activity limitation and emotional function were significantly higher than the control group(P<0.001 for all).Conclusion The individualized health education to the asthmatic children can improve the quality of life of their parents.

Objective Type A lamins are encoded by LMNA and a major component of the nuclear lamina, which have been suggested to play important roles in chromatin organization, transcription, DNA replication, and cell apoptosis. The aim of this study was to analyze the bioinformation of zebrafish lamins. Methods A phylogeny analysis was figured out with protein sequences of different species by Clustal X and MEGA 4?0 software. Then we compared the lamin protein sequences of different species with that of zebrafish by BLAST tool from NCBI. A figure of synteny analysis results was done with lamin sequence information of humans, murine and zebrafish cited from UCSC, Vega and Ensemble. Results The a?nalysis results showed that lmna, lmnb1, and lmnb2 genes of zebrafish are highly conservative and they may be homology of human LMNA, LMNB1 and LMNB2 genes. Conclusions Zebrafish lamins and human lamins have homologous sequence similarity, indicating that these two genes are orthologous genes.

Objective To investigate the clinical features, diagnosis, treatment and prognosis of muhisystemic invasive fungal diseases. Methods Twenty-one patients with multisystemic invasive fungal diseases who were hospitalized in department of infectious diseases from January 2001 to June 2008 were retrospectively reviewed. The pathogenic bacteria, involved organs, underlying diseases, clinical manifestations, treatments and prognoses of muhisystemic invasive fungal diseases were analyzed. Results Among 21 recruited cases, 17 had underlying diseases and 11 were treated with long-term immunosuppressive agents. The main pathogenic bacteria were Cryptococcus neoformans, Aspergillus and Candida parapsilosis. Lung and brain were involved in 16 cases (skin involve in 2 cases and lymph node involved in 1 case simultaneously), lung and lumbar involved in 2 cases, heart valves involved in 2 cases, and liver, spleen and bone marrow involved in 1 case. Eight cases were cured, 6 were improved and 7 died. Conclusions In this study, most of the 21 cases with multisystemic invasive fungal diseases are immunocompromised. The main pathogenic bacterium is Cryptococcus neoformans. The lung and brain are common organs involved. Prognosis is associated with early diagnosis and active anti-fungal treatment.

Objective To explore the effects of vinblastine on abcb4 tumor resistance gene expression in early development zebrafish and lay an important foundation for multi-drug resistant antineoplastic screening in zebrafish model.Methods Zebrafish embryos of 0.5~1.5 hours post-fertilization were exposured to different concentrations of vinblastine, and then calculated the IC50 of vinblastine.Zebrafish embryos of 0.5~1.5 hours post-fertilization were treated with different concentrations of vinblastine and embryo culture medium respectively, and then observed zebrafish embryo development in 24~120 hours post-fertilization and recorded the number of death, hatch and malformation.Evaluating the impact of vinblastine on abcb4 gene expression in zebrafish with quantitative real-time PCR and whole-mount in situ hybridization by collecting zebrafish embryos exposed to different concentrationsof vinblastine.Results Vinblastine IC50 in zebrafish embryos was 3.08 μmol/L.The mRNA level of abcb4 gene in vinblastine treated embryos was significantly increased compared to blank control group.Moreover, abcb4 gene positive hybridization signals were found in the small intestine of zebrafish embryos after 120 hours post-fertilization and also found in the brain and heart of zebrafish embryos by the method of whole-mount in situ hybridization.Conclusions Vinblastine can significantly increase the expression level of abcb4 tumor resistancegene in early development zebrafish embryos, which indicates that zebrafish can be used as a tumor resistant drug screening model.

Objective Lamins are the major components of nuclear lamina underneath the inner nuclear membrane (INM).Lamins express in most cells and are involved in the whole process of growth, also play a major role in cell stability and embryonic development.Mutant in human LMNA gene may lead to a series of disorders, which are similar to progeria or other aging-associate syndrome.In this study, we report a new lmna knockdown animal model generated in our laboratory in order to provide a useful tool for studying laminopathies.Methods Two plasmids tagged to zebrafish lmna gene were designed based on morpholino oligonucleotides technology.Co-microinjected the plasmids into zebrafish embryos to knockdown lmna gene.Imagining and western blot detection were used to identify the mutants.Results Two different proteins, Lamin A/C, were expressed in the zebrafish embryos.Two plasmids lmna-MO and lmna-EGFP-pCS 2 + were generated and co-microinjected into embryos.The results of imagining and western blot showed that the expression of lmna gene was downregulated in the zebrafish embryos.Conclusions Lamin A/C are expressed in zebrafish.lmna gene can be knocked down by the injection of lmna-MO and lmna-EGFP-pCS 2 +.This new animal model may be a powerful tool for study on laminopathies.

Objective To choose zebrafish as the experimental animal model for studying the spatiotemporal expression rule of rap1 gen in zebrafish embryo early development process .Methods The Rap1 gene fragment was cloned from the zebrafish emby‐oscDNA ,then the Rap1 gene fragment and pCS2+ plasmid were performed the in vitro connetion and recombination was extracted , the combinant plasmid was correct after the double enzyme digestion ,colony PCR and sequencing identification .T3 RNA polymer‐ase in vitro transcription system was used to obtain the digoxin (DIG)‐labeled anti‐sense mRNA probe of Rap1 gene .The whole mount in situ hybridization method was adopted to detect the Rap1 expression in zebrafish embryo early development process . Results The positive hybridization signal of Rap1 gene was detected at the cell division junction region of 0 .75 hpf ,animal pole of 3 .70 hpf and 6 .00 hpf ,and notochord of 12 .00 -72 .00 hpf .Conclusion Rap1 gene might be involved in the early development process of notochord nervous system in zebrafish .

Objective To evaluate clinical features,therapeutic effects and outcomes of patients with non-human immunodeficiency virus(HIV)-infected cryptococcal meningitis treated with fluconazole or fluconazole and flucytosine.Methods Twenty-four cases of non-HIV-infected cryptococcal meningitis(fluconazole with or without flucytosine as initial therapy)in Huashan Hospital,Fudan University from 1997 to 2007 were retrospectively reviewed.Clinical manifestations,therapeutic effects and outcomes of the patients were collected.Results Fluconazole was administered with median dosage of 400 mg/d,for a median duration of 20.5 days.After fluconazole initial therapy for 2 weeks,16.7% showed partial response,83.3% showed no response,and the overall response rate was 16.7%.After 10 weeks,33.3% showed partial response,29.2% showed complete response,16.7% showed no response,and the overall response rate was 62.5%.Mortality at week 10 was 20.8%.Twenty-two patients who failed to respond to initial therapy were switched to other antifungal drugs(amphotericin B,amphotericin B colloidal dispersion,itraconazole)or other fluconazole containing combined therapy.Eleven out of the 24 patients died during one-year follow-up,8 of whom died of eryptococcal meningitis,and 3 died of other diseases.Conclusions The initial therapy of fluconazole with or without flucytosine is inefficient,and most of the patients need other antifungal drugs because of initial therapy failure.Therefore,fluconazole might not be appropriate for initial therapy in non-HIV-infected cryptococcal meningitis.