Objective To study the surgical treatment of nodular goiter.Methods The surgical treatment effects of 248 cases with nodular goiter were reviewed.Results 123 paitients were cut off the merely nodle,83 patients suffered one side subtotal lobectomy,32 patients suffered doublr subtotal lobectomy, 10 patients suffered one side merely nodle plus oppside subtotal lobectomy, and 12 patients received operations twice,including 1 case (temporarily) of permanent injury of parathyroid, 1 case(temporarily) of injury of recurrent laryngeal never,3 cases of postoperative hemorrhage.All patients were followed up from 1 to 8 years,and no relapse was noted after operation.Conclusion One side thyroid gland nodle or nodles should cut off the merely nodle and it is unneceeary to deal with the blood vessel of the thyroid up and down,one side or double side thyroid gland nodles tightly should operated subtotal lobectomy, to ligate the blood vessel of the thyroid down, not to dispose the recuyyent laryngeal nerve,reserving the left over gland in cyst,and to prevent hypothyroidism and recurrent laryngeal nerve.

Objective To explore the effects of progressive relaxation training on the nailfold microcirculation for psychological stress state population .Methods According to the mental health screening criteria ,60 cases of psychological healthy individuals were selected as the research object ,took the attention distribution test as psychological stress stimulation ,test self rating anxiety scale(SAS) and nailfold microcirculation function changes of test before and after stress .60 cases were divided into intervention group and normal control group ,30 cases in each group .The intervention group adopted progressive relaxation training intervention after stress ,while normal control group taking natural rest ,then detected the change of nailfold microcirculation .Results The SAS level and the nailfold microcirculation parameters before and after stress between the two groups were significantly different (P<0 .05);the difference of nailfold microcirculation morphological integral and the total integral between the two groups were statisti-cally significant(P<0 .01);and there were no difference on flow integral and around the loop integral between the two groups (P>0 .05) .Conclusion Progressive relaxation training can effectively improve the microcirculation state of the psychological stress a-mong people ,under certain conditions ,the effective intervention to the stress state population can influence the microcirculation .

Objective To establish a TaqMan probe-based real-time fluorescent quantitative PCR ( real-time PCR) for the quantitative and rapid detection of viral reservoir in peripheral blood mononuclear cells (PBMCs) isolated from rhesus monkeys with simian immunodeficiency virus (SIV) infection and to evaluate its preliminary application. Methods A pair of primers and one TaqMan probe were designed ac-cording to the conserved sequence of SIVmac239 strain for real-time PCR amplification. A length of 2 090 bp of nucleotide fragment was digested from the plasmid p239SpSp5 containing 5′-end long segments of SIV-mac239 strain by restriction enzymes EcoRⅠand SpeⅠ. The standards used for quantitative detection of SIV DNA in peripheral blood samples were prepared by a 10-fold serial dilution and used for graphing the stand-ard curve. The numbers of SIV DNA ( copies per 106 PBMCs) in rhesus monkeys during acute and chronic phases of SIVmac239 infection were determined and the virological characteristics of SIV DNA at different phages of infection were analyzed. Results A linear positive correlation between cycle threshold ( Ct) val-ues and concentrations (10 copies/μl to 109 copies/μl) of the standards was found. High levels of SIV DNA were monitored in SIV-infected monkeys 14 to 22 days after acute infection. The levels of SIV DNA in the acute phase of infection were about 1 to 2 logs higher than those in the chronic phase of infection. The num-bers of SIV DNA ( copies per 106 PBMCs) were 1 log lower than the SIV viral load in peripheral blood of the same monkey. The ratios of SIV DNA load to SIV RNA load ( DNA/RNA) in chronic phase of infection were higher than those in the acute phase. Conclusion The established TaqMan probe-based real-time fluorescent quantitative PCR was a highly sensitive and specific assay for the detection of SIV DNA with an advantage of wide linear range. It could be used for the quantitative evaluation of latent reservoirs of SIV.

OBJECTIVE To investigate the management situation of cross infection in outpatient service of stomatology in hospital and clinic in Zhanjiang city and conduct effective measure to control hospital infection.METHODS In our investigation,we selected 105 hospitals and private clinics to inspect their management situation of cross (infection) via dental(instrument).RESULTS The management in the hospitals of the city was quite qualified but the some private dental clinics were terrible.The main problems were as follows: no effective disinfection for dental instrument and the bad environment in procedure room,especially the worse sterilization situation of the dental handpieces.Most of the doctors in private clinics were short of knowledge in the sterilization for dental(instruments.) CONCLUSIONS There is no time to delay for the health administration department to normalize the management of the private dental clinics.It is essential to train the medical staffs,and implement measures for dental instrument disinfection management in private dental clinics.

Objective:To investigate the prevenlence of insomnia on workers and related influcecing factors in chip manufacturing industry.Methods:By using cluster sampling method, 2 251 workers in chip manufacturing industry were selected as study subjects. The simple Job Demand-Control model Questionnnaire (JDC) , Effort-Reword Imbalance (ERI) Questionnnaire and Insomnia Symptoms Scale were used to evaluate JDC occupational stress, ERI occupational stress and insomnia symptoms respectively.Results:22.6% (509/2251) workers were found high level of insomnia. The risk factors of insomnia symptoms were high score of effort and overcommitment ( P< 0.05) . The risk of insomnia symptoms in high effort was 1.689 times that of low score (95% CI: 1.334-2.138) . The risk of insomnia symptoms in high overcommitment was 1.835 times that of low score (95% CI: 1.461-2.305) . The protective factors for insomnia symptoms were women, monthly income of more than 3000 yuan, college dregree or above, high work control and high reward ( P<0.05) . Conclusion:The high scores of effort and overcommitment are the risk factors for insomnia symptoms of employees in manufacture electronic devices. Enterprises should take comprehensive measures to pay attention to the occurrence of insomnia symptoms among employees with high score of effort and overcommitment.

Objective:To investigate the prevenlence of insomnia on workers and related influcecing factors in chip manufacturing industry.Methods:By using cluster sampling method, 2 251 workers in chip manufacturing industry were selected as study subjects. The simple Job Demand-Control model Questionnnaire (JDC) , Effort-Reword Imbalance (ERI) Questionnnaire and Insomnia Symptoms Scale were used to evaluate JDC occupational stress, ERI occupational stress and insomnia symptoms respectively.Results:22.6% (509/2251) workers were found high level of insomnia. The risk factors of insomnia symptoms were high score of effort and overcommitment ( P< 0.05) . The risk of insomnia symptoms in high effort was 1.689 times that of low score (95% CI: 1.334-2.138) . The risk of insomnia symptoms in high overcommitment was 1.835 times that of low score (95% CI: 1.461-2.305) . The protective factors for insomnia symptoms were women, monthly income of more than 3000 yuan, college dregree or above, high work control and high reward ( P<0.05) . Conclusion:The high scores of effort and overcommitment are the risk factors for insomnia symptoms of employees in manufacture electronic devices. Enterprises should take comprehensive measures to pay attention to the occurrence of insomnia symptoms among employees with high score of effort and overcommitment.

Objective To explore the effects of PDCA cycling scheme application for nurses and hospital patients with refractory pulmonary tuberculosis. Methods A total of 100 patients with refractory pulmonary tuberculosis were selected as the research objects, and were divided into control group and observation group according to the nursing mode of patients accepted, each group of 50 cases. The patients of control group were given conventional nursing, while the patients of observation group were treated the nursing mode by nurses who trained PDCA cycling method. Before and after training, nurses in two groups were examined the theoretical knowledge and operative skills of refractory pulmonary tuberculosis and the scores of exam were compared between two groups. The medical compliance and self-efficacy were compared between two groups. Results After the training , the theoretical knowledge and operative skills of refractory pulmonary tuberculosis scores of 25 nurses were obviously higher than those of before (t=10. 583, 12. 457;P<0. 01). After nursing in the observation group, patients′ medical compliance, nutrition and rest, drug treatment, protective measures and incidences of regular check on time were apparently higher than those of the control group (t=18. 438, 11. 237, 13. 462, 15. 442, 19. 598;P <0. 01). The scores of no indications, taking medication as order, regular check on time, mood management, reasonable rest, diet management and self-efficacy in the observation group were apparently higher than those of the control group ( t =4. 561, 4. 016, 5. 128, 5. 815, 4. 924, 6. 425, 13. 521;P<0. 01). Conclusions The PDCA cycling training method not only can effectively promote the nurse theoretical knowledge and skills, but also can effectively improve the patients compliance and self-efficacy, so it is worth to promote the clinical promotion.

Chymosin is an important industrial enzyme widely used in cheese manufacture. To improve expression efficiency of recombinant bovine chymosin in Kluyveromyces lactis strain GG799, we designed and synthesized a DNA sequence encoding bovine prochymosin gene (GenBank Accession No. AA30448) by using optimized codons. The synthesized prochymosin gene was amplified by two-step PCR method, and then cloned into the expression vector pKLAC1, resulting in pKLAC1-Prochy. pKLAC1-Prochy was linearized and transformed into K. lactis GG799 by electrotransformation. Positive clones were screened by YEPD plates containing 1% casein. A recombinant strain chyl with highest activities and multi-copy integration which was detected by using specifical integration primers was chosen and fermented in flask. Prochymosin was expressed in K. lactis successfully. SDS-PAGE analysis revealed that the purified recombinant bovine prochymosin had a molecular mass of 41 kDa. After acid treatment, molecular weight of chymosin is about 36 kDa, the same as native bovine chymosin. Activity tests showed that the chymosin activity of the culture supernatant was 99.67 SU/mL after 96 h cultivation. The activities of chymosin were not prominent increased when galactose was used as carbon source instead of glucose, which proved that the fermentation of recombinant strain does not need galactose inducing. The recombinant K. lactis strain obtained in this study could be further used to produce recombinant chymosin for cheese making.
Animals ; Cattle ; Chymosin ; biosynthesis ; genetics ; Enzyme Precursors ; biosynthesis ; genetics ; Gene Expression Regulation, Fungal ; genetics ; Genetic Vectors ; genetics ; Kluyveromyces ; genetics ; growth & development ; metabolism ; Protein Engineering ; Recombinant Proteins ; biosynthesis ; genetics

Objective:To investigate the relationship between TP53 gene mutation and overall survival (OS) time of myelodysplastic syndrome (MDS).Methods:Databases, including PubMed, Cochrane Library and Embase were searched for relevant studies published up to 20 October, 2019. The corresponding hazard ratio ( HR) and their 95% confidence interval ( CI) for OS from multivariate Cox proportional hazard models were extracted. The combined HR with their 95% CI was calculated by using fixed or random effect models. Meta-analysis was performed by using Revman 5.3 software. Results:A total of 1 033 patients from 6 studies were enrolled. Meta-analysis results showed that OS time in TP53 gene mutation group was shorter than that in wild type group for patients with MDS ( HR = 2.16, 95% CI 1.52-3.07, P < 0.01). The prognostic risk for post-transplantation patients with MDS ( HR = 2.69, 95% CI 1.63-4.43, P < 0.01) was lower compared with that for patients treated by azacitidine( HR = 2.89, 95% CI 1.37-6.08, P = 0.005). Conclusion:TP53 gene mutation is a risk factor affecting OS of MDS patients.

Objective:To investigate the association between the rehabilitation of visual function and retinal nerve fiber layer (RNFL) thickness in Leber hereditary optic neuropathy (LHON) patients receiving gene therapy for the disease.Methods:A multi-center, non-randomized, single-arm clinical trial was conducted.A total of 159 LHON patients were enrolled in Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Taihe Hospital and Ezhou Central Hospital from December 2017 to December 2018.All of the patients were administered with a single unilateral intravitreal injection (0.05 μl) of recombinant adeno-associated virus 2 carrying reduced nicotinamide adenine dinucleotide dehydrogenase subunit 4 (rAAV2-ND4) and were followed up before and 1, 3, 6 and 12 months after treatment.The best corrected visual acuity (BCVA) converted to logarithm of the minimum angle of resolution (LogMAR) unit was assessed with a standard logarithmic visual acuity chart.Perimetry indicators including visual field index (VFI) and mean deviation (MD) were measured with Humphrey Field Analyzer.RNFL thickness in the superior, inferior, temporal, nasal optic disc and the average RNFL thickness were detected with Spectralis ? HRA+ OCT.The 12-month postoperative BCVA, visual field, and RNFL thickness were taken as the primary outcomes.According to the improvement of BCVA, VFI and MD at 12 months after therapy, there were 81 vision improved eyes with injection, 62 vision unimproved eyes with injection, 65 vision improved eyes without injection, and 78 vision unimproved eyes without injection, 48 VFI improved eyes with injection, 71 VFI unimproved eyes with injection, 47 VFI improved eyes without injection, and 72 VFI unimproved eyes without injection, 52 MD improved eyes with injection, 67 MD unimproved eyes with injection, 47 MD improved eyes without injection, and 72 MD unimproved eyes without injection.The correlations between BCVA, VFI, MD and RNFL thickness were evaluated by Pearson linear correlation analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committees of Wuhan Tongji Hospital (No.TJ-IRB20180316), Taihe Hospital (No.2017-01), Ezhou Central Hospital (No.2017-K-05) and People's Hospital of Wuhan University (No.WDRY2020-K202).Written informed consent was obtained from each patient or custodian prior to entering the study cohort. Results:Among the patients receiving rAAV-ND4 gene therapy, the 12-month postoperative BCVA (LogMAR) in the injected eyes and uninjected eyes was 1.37±0.55 and 1.29±0.59, which were significantly better than 1.70±0.41 and 1.53±0.51 before treatment (baseline), respectively ( t=4.920, 3.550; both at P<0.001).The 12-month postoperative VFI of the patients were significantly improved and the 12-month postoperative MD of the patients were significantly lowered in comparison with those at baseline in the injected eyes (both at P<0.001).Similar improvements of VFI and MD were observed in the uninjected eyes (both at P<0.01).RNFL of the patients was thinner after the therapy.In the vision improved eyes with injection, the BCVA was negatively correlated with superior, inferior, temporal, nasal and average RNFL thickness ( r=-0.362, -0.292, -0.307, -0.308; all at P<0.05).In the VFI improved eyes with injection, VFI was positively correlated with superior, inferior, nasal and average RNFL thickness ( r=0.439, 0.356, 0.294, 0.401; all at P<0.05).In the MD improved eyes with injection, MD was positively correlated with superior, inferior, nasal and average RNFL thickness ( r=0.495, 0.424, 0.377, 0.474; all at P<0.05). Conclusions:The recovery of visual function is associated with RNFL thickness after the intravitreal injection of rAAV2-ND4 in LHON eyes.Recovery of visual acuity is better in the eyes with thicker RNFL.