Objective By the reform of vocational nursing Maternal and Child Care course teaching methods,to solve the problems existing in higher vocational curriculum in five-year nursing specialty such as too much repetition in teaching content,low learning interest and enthusiasm in students,and not being able to reach target level of personnel training effectively.Methods Higher vocational nursing class 2 (51students) were extracted as the experimental group,class 3 (50 students) were extracted as as the control group from grade 2009.The experimental group adopted the project teaching method,the control group used the traditional teaching method.At the end of the course,the results of knowledge and operating skills between the two groups were compared.Results The total scores of the experimental group were better than the control group in memorizing theoretical knowledge examination,interpretation,application.There were no differences in individual skill examination skills assessment between the two groups,comprehensive skills assessment and total scores of the experimental group was better than the control group.Conclusions Application of project teaching method in higher vocational nursing specialty maternal and child care course teaching in higher vocational cohesion.It can effectively avoid the repetition of teaching content which may lead to the low utilization rate in class,stimulate students' interest in learning,and develop students' comprehensive occupation ability,and make vocational course objectives to achieve high stage.

Occupational therapy provides protective and corrective non-surgical measures for carpal tunnel syndrome. The information gained from the assessment process can help the occupational therapists determine the targets and treatment options, including the nerve-gliding exercises, tendon-gliding exercises, production or select splints, modification of tasks resulting in patients with exacerbations, modification of equipment and environment, transformation of daily necessities. The education would cover the pathophysiology of carpal tunnel syndrome, treatment options (conservative management and surgery), posture and activity modification principles. This information can also be provided in the form of an education booklet which participants will be encouraged to review at home.

Objective To analyze retrospectively the relationship between protein nutrition index (PNI) and survival conditions in patients with peritoneal dialysis (PD).Methods Various clinical and laboratory indexes of patients with chronic kidney disease from January 2004 to January 2014 were analyzed retrospectively.PNI score was determined by serum albumin (ALB),normalized protein nitrogen presentation rate (nPNA),lean body mass (LBM).According to PNI score,PD patients were divided into four groups:good nutrition status,nutrition status in general,poor nutrition,PEW status.Linear regression analysis was used to analyze determine factors of PNI;analysis of Kaplan-Meier was applied to examine relationship between the protein nutrition status and survival rate;COX regression analysis was used to analyze the risk factors for survival in patients with PD.Results All the indexes,age,complications index,serum Cr,K-Kt/V,T-Kt/V had a linear relationship with PNI.5-year survival rate in the four groups were respectively 95％,92％,65％,23％.Age,complications,PNI index were the survival risk factors of PD patients.Conclusions According to PNI score,evaluation of protein nutritional status of patients with PD could predict survival conditions of PD patients,the higher PNI score,the higher survival rate.

This study aims to investigate the current situation of the enrollment , training model and career planning of medical students in the targeted admission program .After analyzing the implementation process of this targeted admission policy in medical education , we raised some feasible strategies to increase the attraction and reten-tion of health professionals in rural China .The study covered 4 medical universities in central and western China .A cohort of 308 medical graduates from this targeted admission program were recruited in June 2015 .A baseline survey , including questionnaire survey , in-depth interviews and the focus group discussions , were conducted right before their graduation .The first follow-up online survey was done 6 months after their graduation .he findings of this investiga-tion show that 72.9%of the investigated students in the program used to live in rural areas before 15 years old.The average annual household income was 28,200 Yuan.The top three reasons of choosing this program were guaranteed job after graduation , low performance in the college entrance examination , and wavier of tuition fee .There were sig-nificant differences of implementation of this policy between different provinces , especially the contract-signing and job deployment .Income and working environment were the main influencing factors of the medical graduates 'job-see-king intention .Based on the findings of this study , it can be concluded that the targeted admission program is rather successful in attracting medical graduates for rural health services .However , extra efforts are needed to improve the implementation of the policy and to retain the medical graduates in rural area .

Objective:To investigate the application effect of situational simulation combined with the Debriefing-GAS method in the teaching of prenatal genetic counseling.Methods:A total of 30 medical students of the five- and eight-year programs in the classes of 2017 and 2018 who received genetic counseling training in The First Affiliated Hospital of Sun Yat-sen University from May 2021 to May 2022 were selected as research subjects, and situational simulation combined with the debriefing-GAS method was used for the teaching of prenatal genetic counseling. Assessment was performed by the teacher to evaluate the change in genetic counseling abilities during the teaching process, and a questionnaire survey was conducted to investigate the degree of satisfaction with teaching among the students. SPSS 26.0 software was used for data analysis; normally distributed continuous data were expressed as mean±standard deviation, non-normally distributed continuous data were expressed as M d(P 25,P75), and categorical data were expressed as frequency and rate; the paired samples t-test was used for comparison of assessment scores before and after teaching. Results:After teaching, there were significant increases in the assessment scores of genetic counseling [(74.5±18.6) points vs. (87.2±14.5) points, t=4.10, P<0.001] and comprehensive abilities such as clinical ability [(35.4±9.6) points vs. (41.1±6.9) points, t=3.72, P=0.001], doctor-patient communication [(17.5±4.6) points vs. (20.8±3.8) points, t=4.34, P<0.001], professional literacy [(11.0±2.5) points vs. (12.5±2.3) points, t=2.89, P=0.007], teamwork [(3.5±1.0) points vs. (4.2±0.8) points, t=3.67, P=0.001], and organizational effectiveness [(7.1±2.0) points vs. (8.3±1.7) points, t=2.94, P=0.006]. The questionnaire survey showed that the degree of satisfaction among students was rated above satisfaction for the reasonability of the implementation process and links of genetic counseling teaching [3.0 (3.0, 4.0) points], teaching quality [3.5 (3.0, 4.0) points], whether the teaching model could effectively increase the interest and initiative in learning [4.0 (3.0, 4.0) points], the improvement in theoretical knowledge [4.0 (3.0, 4.0) points], communication skills in genetic counseling [3.0 (3.0, 4.0) points], and the understanding of related techniques and application prospect [3.0 (3.0, 4.0) points]. However, two students (6.7%) thought that this teaching model could not efficiently reach teaching objectives, since the teaching process was slightly complicated. Conclusions:Situational simulation combined with the debriefing-GAS method has achieved a good effect in the teaching of prenatal genetic counseling and can help undergraduates to master the theoretical knowledge of prenatal genetic counseling and improve their comprehensive clinical abilities, with a relatively high degree of satisfaction, and therefore, it holds promise for clinical application.

Objective? To evaluate the effect of physical restraintreduction strategy on improving the physical restraint practice of critical patients. Methods? Using convenient sampling method, the inpatients in the Intensive Care Uni(t ICU)of the Emergency Department of a ClassⅢ Grade A hospital in Beijing in 2017 and 2018 were selected as the research objects. According to the length of stay, the inpatients in 2017 were divided into two groups: the control group (n=282), the intervention group (n=263), the control group was given regular physical restraint strategy, and the intervention group used the developed physical restraint reduction strategy to implement the physical restraint. The rate of physical restraint, time of physical restraint, delirium, unplanned extubation and skin abnormality were compared between the two groups. Results? In the intervention group, the rate of physical restraint was 23.57%, and the rate of unplanned extubation was 1.14%, which was lower than that in the control group, the differences were statistically significant (χ2=26.830, 4.142; P＜ 0.05). The restraint time of the intervention group was (49.63±146.94) h, and that of the control group was (93.62± 186.35) h, the difference was statistically significant (t=10.04, P＜0.05). There was no significant difference in the incidence of delirium and skin abnormality between the two groups (P＞0.05). Conclusions? The strategy of body constraint reduction is helpful to reduce the rate of body constraint, the time of constraint and the rate of unplanned extubation.

【Objective】 To establish and improve the emergency recruitment strategy of voluntary blood donors under public health emergencies in Shenzhen and verify its effectiveness. 【Methods】 Blood donor recruitment strategies under routine, emergency and combined situation were developed. The blood collection data from 2017 to 2019 before the outbreak of COVID-19 pandemic was used as the control group, and those from 2020 to 2022 after the outbreak was used as the experimental group, and the feasibility and effectiveness of this emergency recruitment strategy was confirmed through statistical analysis of key indicators of blood collection and supply. 【Results】 Through the application of the emergency recruitment strategy for blood donors in Shenzhen under public health emergencies, statistical analysis of the experimental group and the control group showed a year-on-year increase of 14.11%(73 647.25/521 855.5) in whole blood collection, 42.33%(28 891.47/68 250.95) in platelet collection, 0.33%(529/161 033) in first-time donors, 33.25%(3 154/9 487) in repeated donors and 16.78%(32 585/194 149) in the number of 400 mL donors. The inventory of various types of red blood cell maintained between 6-18 days. After the implementation of the emergency recruitment strategy the blood donation population has shown characteristics as younger age, localization, increased repeated donation and a higher proportion of donors with college education or above. 【Conclusion】 The emergency recruitment strategy of blood donors under public health emergencies is feasible and effective, which can quickly and efficiently improve the blood recruitment ability.

ObjectiveTo investigate the effects of cathodic transcranial direct current stimulation (ctDCS) on upper limb and finger dysfunction after right brain injury (RBI). MethodsFrom October, 2020 to May, 2022, 40 RBI patients in Beijing Bo'ai Hospital were randomly divided into control group and experimental group, with 20 patients in each group. All the patients accepted conventional drug treatment, conventional rehabilitation treatment and functional occupational therapy. The cathode electrode was placed in the M1 area of the uninjured side of brain, then the control group received sham stimulation and the experimental group received stimulation, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and -Finger, and the modified Barthel Index (MBI) before and after treatment. ResultsAfter treatment, the scores of FMA-UE, FMA-Finger and MBI improved in the two groups (t > 5.627, P < 0.001), and improved more in the experimental group than in the control group (t > 2.161, P < 0.05). ConclusionctDCS can effectively improve the motor function of upper limbs and fingers of RBI patients, and improve the ability of activities of daily living.

Objective: To study the characteristics of gene mutations in Chinese myelodysplastic syndromes (MDS) patients. Methods: A total of 511 Chinese patients with MDS performed 112-gene targeted sequencing were retrospectively analyzed. Results: Eighty-three distinct mutant genes were found in 511 patients with MDS. Amongst these, the most frequent mutations was associated with epigenetics (50%) , followed by spliceosome (37%) , signal transduction (34%) , transcription factors (24%) and cell cycle/apoptosis (17%) . 439 subjects (86%) had at least one gene mutation. The mean number of mutations in refractory anemia with unilineage dysplasia (RCUD) was 1.25, refractory anemia with multilineage dysplasia (RCMD) was 1.73, refractory anemia with ring sideroblasts (RARS) was 2.79, refractory anemia with excess blasts-1 (RAEB-1) was 2.22, RAEB-2 was 2.34, MDS with isolated 5q- was 2.67, MDS, unclassified (MDS-U) was 2.00. U2AF1 mutant subjects were more likely to have isolated+8[Q<0.001, OR=4.42 (95% CI 2.23-8.68) ]and less likely to have complex karyotypes[Q=0.005, OR=0.22 (95% CI 0.04-0.72) ]. According to the number of gene mutations, all subjects were categorized into three groups, namely group with 0-1 mutation, with 2 mutations and with three or more mutations. There was a significant difference in overall survival (OS) among three groups (P=0.041) . Conclusion About 90% patients with MDS have at least one gene mutation. Genes associated with epigenetics and spliceosome are most common mutated genes in MDS. The increased numbers of gene mutations accompany with disease evolution and associate with poor prognosis.

Background::To date, there is no effective medicine to treat coronavirus disease 2019 (COVID-19), and the antiviral efficacy of arbidol in the treatment for COVID-19 remained equivocal and controversial. The purpose of this study was to evaluate the efficacy and safety of arbidol tablets in the treatment of COVID-19.Methods::This was a prospective, open-label, controlled and multicenter investigator-initiated trial involving adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients were stratified 1:2 to either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 14 days). The primary endpoint was negative conversion of SARS-CoV-2 within the first week. The rates and 95% confidential intervals were calculated for each variable.Results::A total of 99 patients with laboratory-confirmed SARS-CoV-2 infection were enrolled; 66 were assigned to the SOC plus arbidol tablets group, and 33 to the SOC group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group (70.3% [45/64] vs. 42.4% [14/33]; difference of conversion rate 27.9%; 95% confidence interval [CI], 7.7%-48.1%; P = 0.008). Compared to those in the SOC group, patients receiving arbidol tablets had a shorter duration of clinical recovery (median 7.0 days vs. 12.0 days; hazard ratio [HR]: 1.877, 95% CI: 1.151-3.060, P = 0.006), symptom of fever (median 3.0 days vs. 12.0 days; HR: 18.990, 95% CI: 5.350-67.410, P < 0.001), as well as hospitalization (median 12.5 days vs. 20.0 days; P < 0.001). Moreover, the addition of arbidol tablets to SOC led to more rapid normalization of declined blood lymphocytes (median 10.0 days vs. 14.5 days; P > 0.05). The most common adverse event in the arbidol tablets group was the elevation of transaminase (5/200, 2.5%), and no one withdrew from the study due to adverse events or disease progression. Conclusions::SOC plus arbidol tablets significantly increase the negative conversion rate of SARS-CoV-2 within the first week and accelerate the recovery of COVID-19 patients. During the treatment with arbidol tablets, we find no significant serious adverse events.Trial registration::Chinese Clinical Trial Registry, NCT04260594, www.clinicaltrials.gov/ct2/show/NCT04260594?term= NCT04260594&draw=2&rank=1