Guided by the theory of "liver governing the free flow of qi"， it is believed that liver fail to govern the free flow of qi may lead to qi stagnation， phlegm coagulation， and stasis， which is the core pathogenesis of thyroid nodules， breast nodules and uterine fibroids； qi stagnation， phlegm coagulation， and stasis are not only the important pathological products， but also the obstruction to the liver's function， and the two affect each other as the cause of each other. In clinic， it is advocated that using the treatment method of soothing the liver， rectifying qi， and resolving constraint， with prescription of Tongqi Powder （通气散） as the basic formula， and modified according to symptoms. For liver depression and qi stagnation syndrome， the formula chooses modified Tongqi Powder to soothe the liver and rectify qi； for qi stagnation and phlegm coagulation syndrome， the formula chooses modified Tongqi Powder plus Shenling Baizhu Powder （参苓白术散） to soothe the wood and regulate the earth， and resolve phlegm and dissipate masses； for qi stagnation and blood stasis syndrome， the formula applies modified Tongqi Powder plus Taohong Sizu Decoction （桃红四物汤） to move qi and invigorate blood circulation， unblock the collaterals and dispel accumulation. At the same time， according to the characteristics of thyroid nodules， breast nodules， and uterine fibroids and their different disease locations， medicinals were added or subtracted according to the symptoms， so as to treat both the symptoms and the root cause of the disease simultaneously.

Objective To investigate the expression of human epidermal growth factor receptor 2(HER2),carbohydrate antigen 199(CA199)and microtubule-associated protein 1 light chain 3β(LC3B)in gastric canc-er tissues and their relationship with recurrence after radical gastrectomy.Methods A total of 95 patients with gastric cancer who underwent radical gastrectomy in the hospital from January 2021 to December 2022 were retrospectively selected.The expressions of HER2,CA199 and LC3B in gastric cancer tissues and adja-cent tissues were compared,and the clinicopathological characteristics were analyzed.According to the postop-erative recurrence of gastric cancer patients,they were divided into recurrence group(n=19)and non-recur-rence group(n=76).Univariate analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of recurrence in patients with gastric cancer after radical resection.Results The ex-pression levels of HER2,CA199 and LC3B in gastric cancer tissues were significantly higher than those in pa-racancerous tissues(P<0.05).The positive expression rates of HER2,CA199 and LC3B in gastric cancer tis-sues(38.95%,38.95%and 35.79%,respectively)were higher than those in adjacent tissues(9.47%,7.37%and 11.58%,respectively),and the differences were statistically significant(P<0.05).The positive expres-sion rate of HER2 in gastric cancer tissues was significantly different in patients with different TNM stage and lymph node metastasis(P<0.05).There were significant differences in the positive expression rates of CA199 and LC3B in gastric cancer patients with different tumor maximum diameter,TNM stage and lymph node metastasis(P<0.05).The maximum diameter of tumor≥5 cm,TNM stage Ⅲ/Ⅳ,lymph node metas-tasis,positive expression of HER2,positive expression of CA199 and positive expression of LC3B were inde-pendent risk factors for recurrence of gastric cancer patients after radical resection(P<0.05).Conclusion The gene expression and positive expression rates of HER2,CA199 and LC3B in gastric cancer tissues are high,which are related to the maximum tumor diameter,TNM stage and lymph node metastasis.The positive expression of HER2,CA199 and LC3B may increase the risk of recurrence of gastric cancer after radical gastrectomy.

This paper discussed the current education status on medical ethics and styles and the assessment condition in the examination of doctors' qualification， as well as the existing problems and potential solutions by reviewing domestic and foreign literature and summarizing the practice experience. Traditionally， medical ethics and styles have always been integrated into clinical medical practice in China. However， under the modern medical education system， it is challenged to integrate traditional education on medical ethics and styles with the rules of modern medical knowledge. By summarizing the education and assessment status of medical ethics and styles in the examination of doctors' qualification， it is found that the current examination is relatively poor in the evaluation content， and the way of evaluation is not diverse， with lack of curriculum of medical humanities. The solutions suggested are enriching relevant examination content， introducing more and comprehensive evaluation method， and establishing more medical humanities-related courses.

Glutamate decarboxylase, a unique pyridoxal 5'-phosphate-dependent enzyme, catalyzes α-decarboxylation of L-glutamate to γ-aminobutyrate. However, glutamate decarboxylase from different sources has the common problem of poor thermostability that affects its application in industry. In this study, proline was introduced at 13 different positions in glutamate decarboxylase by using the design strategy of homologous sequence alignment between Thermococcus kodakarensis and Lactobacillus brevis CGMCC No.1306. A mutant enzyme G364P with higher thermostability was obtained. Compared to the wild type, thermostability of the mutant G364P was significantly improved, the half-life time (t1/2) at 55 °C and the semi-inactivation temperature (T₅₀ ¹⁵) of the mutant G364P increased 19.4 min and 5.3 °C, respectively, while kcat/Km of the mutant enzyme remained nearly unchanged. Further analysis of their thermostability by molecular dynamics simulations were performed. The root mean square deviation of G364P and root mean square fluctuation in the loop region including G364 were lower than the wild type at 313 K for 10 ns, and G364P increased one hydrophobic interaction in the loop region. It proves that mutation of flexible 364-Gly to rigid proline endows glutamate decarboxylase with enhanced thermostability.
Glutamate Decarboxylase ; Glutamic Acid ; Lactobacillus brevis ; Molecular Dynamics Simulation ; Proline

Objective To investigate and analyze the status and relation among Nesbitt score of high risk pregnancy , uncertainty in illness and anxiety level in pregnant patients .Methods Totally 158 pregnant patients were recruited and investigated with the general information questionnaire , Nesbitt score of high risk pregnancy , Mishel uncertainty in illness scale ( MUIS) and state-trait anxiety inventory ( SAI) .The results were analyzed.Results The Nesbitt score of high risk pregnancy in hospitalized pregnant women was ( 62.69 ± 18.21) points;the score of MUIS was (61.11±13.71) points, which was at a medium level;the score of SAI was (43.96±9.86) points, which was at a medium level .Negative correlation was found between Nesbitt score and MUIS score, and significant positive correlation was found between MUIS and SAI , while no significant positive correlation between Nesbitt score and SAI score .Conclusions According to the Nesbitt score of high risk pregnancy , nurses should judge the cognition of pregnant patients in disease , to evaluate their anxiety level;nurses should explore effective healthy education , to decrease the anxiety level of pregnant patients , so that they can have an optimal attitude to face the treatment and pregnancy outcomes .

An analysis of the results of examination of diagnostics teaching in the middle of the semester of 2008 grade is made to discuss the pnoblems existing in teaching and learning so as to improve the teaching quality.