Relying on the practice platform of P2 laboratory, researchers reform and explore the contents and forms of experimental teaching for pathogenic biology and immunology, creating an innovative experimental teaching system suitable for training medical students' professional quality and innovative ability. By improving teaching conditions (construction of P2 laboratory), improving teaching methods and innovating experimental teaching contents, and introducing comprehensive design experiment, students' consciousnesses of service and biosafety have been strengthened, meanwhile, their ability to analyze and solve problems has been improved, and their critical and creative thinking has been cultivated.

Objective: To screen and identify the mutations in Kawasaki disease by targeted enrichment of genomic region sequencing technique and investigate susceptibility genes associated with coronary artery lesion. Method: This was a case-control study.A total of 114 patients diagnosed as Kawasaki disease treated in Shanghai Children′s Hospital between December 2015 and November 2016 were studied and another 45 healthy children who were physically examined in outpatient department were enrolled as control group. Patients were divided into two groups based on the results of echocardiogram. Peripheral venous blood was obtained from patients and controls. Genomic DNA was extracted. SeqCap EZ Choice libraries were prepared by targeted enrichment of genomic region technology. Then the libraries were sequenced to identify susceptibility genes associated with coronary artery lesion in patients diagnosed as Kawasaki disease.Susceptible genes were identified by Burden test, Pearson chi-square test or Fisher′s exact probability test. Result: There was statistically significant difference in TNFRSF11B(rs2073618)G>C(p.N3K)mutation and GG/GC/CC genotype between Kawasaki disease group and control group(χ²=15.52, P=0.00). There was statistically significant difference in TNFRSF13B(rs34562254)C>T(p.P251L)mutation(χ²=10.40, P=0.01)and LEFTY1(rs360057)T>G(p.D322A)mutation(χ²=8.505, P=0.01)between patients with coronary artery lesions and those without. Conclusion Targeted enrichment of genomic region sequencing technology can be used to do primary screening for the susceptible genes associated with coronary artery lesions in Chinese Kawasaki patients and may provide theoretical basis for larger sample investigation of risk prediction score standard in Kawasaki disease.

Objective? To establish a digital protection system for incontinence-associated dermatitis based on earlier prevention to reduce the incidence of incontinence-associated dermatitis. Methods? Based on the informationization of nursing platform, we run the digital protection system module of incontinence-related dermatitis based on the forward moving of the prevention gateway in Zhejiang Provincial People＇s Hospital. Through comparative study, 108 patients with incontinence and incontinence-related dermatitis from January to March 2018 were randomly selected as the pre-operation data, and 108 patients with incontinence and incontinence-related dermatitis from January to March 2019 as the post-operation data. The nurses of the two groups were observed and compared in terms of their assessment accuracy in patients＇ incontinence risk, position and Incontinence Associated Dermatitis Severity(IADS), clinical staging, and implementation of prevention strategies. Meanwhile, the incidence of incontinence-related dermatitis among all inpatients in the hospital from January to March in 2018 was compared with the same period of 2019. Results? After the operation of the digital protection system for incontinence-related dermatitis based on earlier prevention, the nursing staff's accuracy rate in the risk assessment of incontinence (χ2=38.095,P＜0.01), IADS (χ2=64.901,P＜0.01), clinical staging accuracy (χ2=42.424,P＜0.01) and the implementation of protective measures (χ2=50.000, P＜0.01) had significant statistical differences. The incidence of incontinence-related dermatitis in hospitalized patients decreased from 0.35% before operation to 0.06% after operation with statistical significance(χ2=41.031, P＜0.01). Conclusions? The operation of the digital protection system for incontinence-associated dermatitis based on earlier prevention can reduce the incidence of incontinence-associated dermatitis and improve the prevention and management competence of nursing staff.

Objective:To explore the construction and application of the multi-course evaluation system of Pathogen Biology and Immunology under the mode of online and offline mixed teaching.Methods:A total of 104 students from two classes of clinical major of Grade 2022 in Quanzhou Medical College were studied,and combined online and offline teaching mode was adopted for teaching.A curriculum evaluation system was constructed,including process evaluation,assessment evaluation and summative evaluation.Self-efficacy,self-learning ability,course questionnaire and other aspects were statistically analyzed before and after the course.Results:The students'normal grades could be reflected objectively by the new curriculum assessment and evaluation system.The final compre-hensive grades were better,and the course passing rate was higher.The paired t-test analysis demonstrated statistically significant improvements in students'learning motivation,learning management,and self-efficacy after the course(P<0.05).However,the differ-ences in information literacy and cooperation ability were not statistically significant compared with those before the course(P>0.05).Course questionnaire survey found that 89.4%students had a high evaluation of the new course evaluation system,which was condu-cive to promoting learning.Conclusion:The newly constructed curriculum assessment system is more scientific and reasonable,which is conducive to improving students'self-efficacy and autonomous learning ability,and promoting students'learning.

Objective To explore the effects of visual management health education model on incontinence-associated dermatitis (IAD) in inpatients.Methods A total of 55 incontinence patients hospitalized in the People's Hospital of Zhejiang Province from February 2017 to February 2018 were selected as the observation group,and visual management health education was carried out.Another 58 incontinence patients hospitalized from January 2016 to December 2016 were selected as the control group,and routine health education was carried out.The incidence and duration of IAD,self-efficacy and nursing satisfaction were compared between the two groups after 1 months of nursing intervention.Results There were 1 cases of first degree dermatitis and 1 case of second degree dermatitis,with a total incidence of 3.64％.There were 6 cases of first degree dermatitis,2 cases of second degree dermatitis,and 1 cases of third degree dermatitis,with a total incidence of 15.52％.The difference was statistically significant (P ＜ 0.01).The duration of IAD of the observation group and the control group was (13.5 ± 3.1) d and (7.6 ± 2.4) d respectively,and the difference between the two groups was statistically significant (P＜ 0.01).The results,coping,self management,general self-efficacy and total score of the patients in the observation group before and after visual management nursing intervention were significantly higher than those in the control group,and all the differences were statistically significant (P ＜ 0.05).The satisfaction on technical operation and clinical nursing quality of the patients in the observation group was higher than that of the control group (P ＜ 0.05).There was no significant difference in the ward environment and service attitude between the two groups (P ＞ 0.05).Conclusions Visual management can reduce IAD and improve self-efficacy and nursing satisfaction of inpatients with incontinence.

Objective? To establish a WeChat online system supporting continued nursing care for patients receiving enteral bladder augmentation and to evaluate its effects on continued nursing care for patients with neurogenic bladder in spinal cord injury who received enteral bladder augmentation. Methods? Totally 60 patients with low-compliant neurogenic bladder in spinal cord injury who received enteral bladder augmentation and were discharged from Zhejiang Provincial People's Hospital between March 2016 and March 2018 were selected by convenient sampling, and divided into the observation group (n=30) and the control group (n=30) according to the random number table. Patients in the control group received conventional nursing care after discharge, while patients in the observation group received nursing care after discharge via the WeChat online support system. The follow-up duration was 3 months. Bladder self-management compliance, urinary catheter-associated complications, bladder function, quality of life and negative emotions at discharge and 3 months after discharge were compared between the two groups. Results? The score of bladder self-management compliance, anxiety score, depression score, and scores of physical function, role function, emotional function and social function in quality of life in the observation group were better than those in the control group 3 months after discharge (P＜0.05); the rates of urinary tract infection and urethral injury of the observation group were 3.3% and 6.7%, while those of the control group were 26.7% and 33.3%, respectively; the incidence rate of urinary catheter-associated complications of the observation group was lower than that of the control group (P＜0.05); and the parameters of bladder function such as bladder volume, bladder compliance, residual urine volume and maximum detrusor pressure of the observation group were better than those of the control group (P＜ 0.05). Conclusions? The WeChat online support system can improve patients' bladder self-management compliance, reduce the urinary catheter-associated complications, enable the recovery of bladder function, ameliorate their negative emotions, and improve their quality of life.

Objective:To explore the influencing factors of pain control among abdominal surgery patients with the enhanced recovery after surgery (ERAS) so as to provide a basis for improving pain control.Methods:From May 2018 to November 2018, we selected 15 abdominal surgery patients with ERAS in Hepatobiliary and Pancreatic Surgery at Zhejiang Provincial People's Hospital by purposive sampling. Semi-structured interview was carried out with the method of phenomenology in qualitative research. Colaizzi 7-step analysis was used in data analysis to conclude themes.Results:By interview data analysis, a total of 5 themes that had influences on pain control were concluded: activity-related pain and pain management after removing patient-controlled analgesia (PCA) ; adverse reaction related to pain management; recognition of patients and their family members on pain or pain treatment; information support for pain treatment; influence of non-medical service on patient satisfaction with pain control.Conclusions:We should explore the operation mode of acute pain service organization suitable for our country. Muti-disciplinary team should be used for abdominal surgery patients to strengthen the management of activity-related pain and removing PCA, prevention and treatment for adverse reaction related to pain treatment, information support for pain treatment, and improve the recognition of patients and their family members on pain or pain treatment, and pay attention to the influence of non-medical service on patient satisfaction with pain control so as to improve pain control.

Objective:To explore the application and effect of information management in nursing of incontinence associated dermatitis (IAD) among elderly patients.Methods:From April 2019, the Cadre Department of Zhejiang Provincial People's Hospital carried out information management of IAD in elderly patients. Relying on the Ding Talk platform to provide nurses with information training and assessment of IAD knowledge, and to carry out information management of skin management in the elderly incontinent patients. Using before-after study, we randomly selected data of 80 elderly patients from October 2018 to March 2019 as control group, and selected data of 80 elderly incontinent patients from April to September 2019 as experimental group. We observed the incidence and time of IAD between two groups.Results:After information management, the incidence of IAD of experimental group patients was 13.75% (11/80) lower than that 33.75% (27/80) of control group with a statistical difference ( P<0.05) . The time of IAD of experimental group was (10.46±2.01) d, which was significantly later than that [ (5.47±2.29) d] of control group ( P<0.05) . Conclusions:Information management can effectively reduce the incidence of IAD in elderly patients, delay the occurrence time and improve the nursing effect.

Objective: To analyze the current status of work-related musculoskeletal disorders (WMSDs), work fatigue and musculoskeletal pain in Chinese occupational population, and to study the relationship between work fatigue and musculoskeletal pain and WMSDs. Methods: A total of 66 961 employees from 323 enterprises in 15 key industries in China were selected as the study subjects using stratified cluster sampling method. The incidence of WMSDs in the past year was investigated using the Chinese version of the Musculoskeletal Disorders Questionnaire, and the work fatigue and musculoskeletal pain were investigated using Borg 6-20 Rating of Perceived Exertion Scale and visual analogue scale. The data were standardized using the age composition data of 18 to 60 years from the seventh national population census. Results: The standardized annual incidence of WMSDs was higher in the front-line workers than that in the administrative and other supportive staff (38.82% vs 36.30%). The detection rates of work fatigue and musculoskeletal pain in the study subjects were 44.54% and 63.08%, respectively. The result of S-curve fitting showed that the risk of WMSDs increased with the level of work fatigue (P<0.01). Among the front-line workers, the average of monthly fatigue frequency in the neck, shoulder, lower back, upper back, wrist/hand, foot and ankle, knee, leg, and elbow were higher in the group with WMSDs compared to those without WMSDs (all P<0.01). The pain degree of musculoskeletal pain was higher in all nine sites in the fatigued group than in the no-fatigue group (all P<0.01). The standardized detection rate of musculoskeletal pain was higher in the fatigued group than in the non-fatigued group (80.38% vs 25.71%). The work fatigue was moderate and positively correlated with musculoskeletal pain in all seven sites except the lower back and elbow, with Kendall Tau-b correlation coefficients ranging from 0.423 to 0.546 (all P<0.01). Conclusion: There is a good correlation between work fatigue and local musculoskeletal pain, work fatigue and WMSDs in Chinese occupational population. Implementing ergonomic interventions to control the development of work fatigue can be an effective measure for preventing WMSDs.

Background Prolonged awkward postures during occupational activities can lead to excessive musculoskeletal load on the wrist of workers and symptoms such as wrist pain or discomfort. Objective To survey the prevalence of wrist pain among workers in 10 key industries and analyze its correlation with wrist working postures. Methods By using stratified cluster sampling method, workers from 10 key industries, such as footwear manufacturing industry, shipbuilding manufacturing industry, and automobile manufacturing industry, were selected from seven regions in North China, East China, Central China, South China, Southwest China, Northwest China, and Northeast China. The demographic information, wrist working postures, pain in wrist of the workers were collected through a cross-sectional survey. Pearson χ² test was used to compare prevalence by selected factors, trend χ² test for between group comparison, and unconditional logistic regression models for the association of wrist working postures with wrist pain. Results There were 64052 workers enrolled in this survey, and 56286 provided valid questionnaires (the effective rate was 87.8%). According to the survey, the prevalence of wrist pain was 23.3% (13112/56286), and the industries with higher prevalences were footwear manufacturing (27.1%, 1927/7106), automobile manufacturing (24.9%, 5378/21560), and shipbuilding and related equipment manufacturing (24.4%, 850/3488) industries. Finger pinching (OR=2.09, 95%CI: 1.95-2.24), frequent wrist bending (OR=2.03, 95%CI: 1.92-2.15), fixed wrist bending (OR=1.77, 95%CI: 1.69-1.85), wrist on hard edge (OR=1.34, 95%CI: 1.28-1.40), and arms over shoulders (OR=1.11, 95%CI: 1.05-1.17) increased the risk of reporting wrist pain. Conclusion Awkward postures are related to wrist pain among workers in selected 10 key industries. The related factors are wrist on hard edge, frequent wrist bending, finger pinching, fixed wrist bending, and arms over shoulders.