Objective: To educate the high-quality nurses with ability and to improve their capability in holistic nursing.Methods: Interlocution of nursing case is applied to theory teaching.Clinic probation and simulative act are applied to practical teaching.Results:Situational teaching method is welcome among the experimental students whose grade is higher than that of the students of contrast class.Conclusion: It is propitious to education in synthesis ability of students to use situational teaching method based on the holistic nursing.

Objective:To investigate the possible association between Thr241Met polymorphism in the DNA repair gene X-ray repair cross-complementing group 3 (XRCC3) with genetic susceptibility to glioma in a Chinese Han population living in Shanghai and the surrounding provinces in east China. Methods: Genotyping by a TaqMan assay was performed in 771 brain glioma patients living in Shanghai and the surrounding provinces (Jiangsu.Zhejiang, Anhui.etc. )and in 752 control participants matched in age and gender. The genotyping results of TaqMan assay and the association between Thr241Met polymorphism in the DNA repair gene XRCC3 with genetic susceptibility to glioma were statistically analyzed. Results: Genotypes of 1 468 subjects (760 with brain glioma and 708 were cancer-free control) were successfully performed by TaqMan assay, with the successful rate being 96.4%. Statistical analysis result showed that gene(C/T) and genotype(C/CT/CT/T) frequencies of XRCC3 were not significantly different between the glioma and cancer-free groups. Compared with the CC genotype, the variant TC(P = 0. 909; adjusted by age and gender OR = 0. 981; 95%CI = 0. 701-1. 371) or TT(P=0. 642; adjusted by age and gender OR = 0. 7; 95%CI = 0. 156-3. 146) genotypes of XRCC3 Thr241Met were associated with a non-statistically significant increase of glioma risk. Conclusion: The variant TC or TT genotypes of XRCC3 Thr241Met may not be risk factors for brain glioma in Chinese Han population living in Shanghai and the surrounding provinces in east China.

Immune checkpoint inhibitors are members of a class of immune-suppressive molecules that regulate the strength and range of immune responses to avoid normal tissue damage. However, immune checkpoint activity can be stimulated by tumors to es-cape immune surveillance. To elicit anti-tumor effects, immune checkpoint inhibitors can promote the activation of T cells by blocking immune checkpoint proteins. Therefore, these inhibitors can be efficiently and safely used to treat solid tumors. Although the clinical usage of these inhibitors is in the initial stage, they have exhibited good efficacy and safety in lymphoma treatment. This review sum-marizes the biological activities of CTLA-4, PD-1, and PD-L1 and the application of antibodies as drugs for lymphoma treatment.

Objective To study the effect of clove oil on bacterial biofilm of Streptococcus pneumoniae. Methods The components of clove oil were determined by GC-MS mass spectrometry. The suspension of streptococcus mutans was prepared to carry out the germicidal test, and to determine the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of clove oil. The effects of different concentrations of clove oil on the formation of biofilm were observed by laser confocal microscopy, and the average fluorescence intensity of live bacteria and dead bacteria in biofilm was recorded. Results Determination of clove oil 8 components were analyzed by GC-MS mass spectrometry method, most of the Eugenol content was 48.93%, followed by the Caryophyllene 20.78%, Methylis salicylas 14.96%. Through MIC, MBC and the experimental results showed that clove oil had antibacterial activity of Proteus, and with the increase of clove oil concentration, the inhibitory effect was better. When it reached a certain concentration, it can showed bactericidal effect that the MIC and MBC were 0.3125%, 0.6250%. The clove oil also had inhibitory effect on Streptococcus mutans biofilm with the concentration depedence. When the concentration of clove oil was 2.5000%, the average fluorescence intensity (live/dead bacteria) was 0.082 ± 0.007, the proportion of living bacteria decreased obviously, and biofilm disappeared. Conclusions The clove oil not only has inhibitory effect on Streptococcus mutants, but also can inhibit and clear the biofilm formation of Streptococcus.

Objective:To explore the clinical value of "hydration therapy" in the treatment of severe acute paraquat poisoning (APP).Methods:A prospective historical control observation was conducted. Fifty-eight patients with severe APP admitted to Shouguang People's Hospital Affiliated to Weifang Medical College from February 2014 to June 2019 were enrolled. Twenty-six patients admitted before May 10th, 2016 were enrolled in the standard treatment group. After being admitted to intensive care unit (ICU) from the department of emergency, patients in the standard treatment group were immediately given standard treatment such as repeated gastric lavage, catharsis, adsorption of poison by activated carbon or montmorillonite powder, drug treatment and blood purification. From May 10th, 2016, 32 patients were enrolled in the intensive treatment group. On the basis of standard treatment, "hydration therapy" was carried out, that was, 0.9% NaCl and/or 5% glucose injection were used for continuous intravenous infusion throughout the day, so as to ensure that the total amount of fluid infusion per day reached 200 mL/kg within 48-72 hours after ICU admission. At the same time, furosemide was used to strengthen diuresis to ensure the balance of water and electrolyte. If heart failure or acute pulmonary interstitial edema occurred during the treatment, "hydration therapy" should be stopped immediately. Six months after treatment, all patients were followed up. The patients with normal activity, no complaints of discomfort and no damage of heart, lung, liver, kidney and other organs were regarded as cured. The therapeutic effect of "hydration therapy" was evaluated.Results:There was no significant difference in gender, age, dosage or time from taking poison to ICU between the two groups. In the intensive treatment group, 32 patients did not appear heart failure during continuous rehydration treatment. Follow-up after 6 months showed that the overall cure rate in the intensive treatment group was significantly higher than that in the standard treatment group [59.4% (19/32) vs. 19.2% (5/26), P < 0.05]. In the 6-month follow-up, there was no significant difference in age or time from taking poison to ICU between the two groups, but the dosage in the intensive treatment group was significantly higher than that in the standard treatment group (mL: 54.06±26.03 vs. 23.00±4.47, P < 0.05). After 6 months of follow-up, chest CT showed that the lesions of pulmonary fibrosis of cured patients in both group gradually reduced with time, not completely progressive and irreversible. Conclusion:"Hydration therapy" with intensive diuresis can significantly improve the rescue success rate of patients with severe APP.

OBJECTIVETo investigate the relationship between semi-quantification of urine paraquat and the severity of acute paraquat poisoning, and to evaluate the prognostic value of the test in patients with acute paraquat poisoning.

METHODSA total of 179 patients with acute paraquat poisoning were categorized into four groups according to their semi-quantification results of urine paraquat: +group (n = 36), ++group (n = 23), +++ group (n = 25), and ++++group (n = 95). The clinical features, severity of hepatic and renal injuries, respiratory failure, and clinical classification were compared between these four groups. Kaplan-Meier analysis was used to evaluate the survival rate.

RESULTSThe 60-day mortality was 45.25% (81/179). The amount of ingestion increased significantly from +group to ++++group (P < 0.05). No patient in +group was found to have serious complications, while most patients in ++++group suffered organ dysfunction or even organ failure. The incidence of acute respiratory failure, renal failure, and hepatic failure in ++++group was significantly higher than that in +group, ++group, and +++group (P < 0.05). The urine paraquat concentration was positively correlated with the clinical severity of acute paraquat poisoning (Spearman correlation coefficient = 0.720, P < 0.01). Kaplan-Meier survival analysis showed that the mortality of ++++group (73.7%) was significantly higher than that of +++group (40%), ++group (4.3%), and +group (0%) (P < 0.05).

CONCLUSIONThe semi-quantification of urine paraquat is a promising test in evaluating the severity of acute paraquat poisoning. This test can be used to guide therapy and to predict the outcomes of patients suffering acute paraquat poisoning.

Acute Disease ; Adolescent ; Adult ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Paraquat ; poisoning ; urine ; Prognosis ; Young Adult