Pseudorabies virus(PRV)is the etiological agent of pseudorabies in pigs,which is char-acterized by dyspnea,reproductive disorders,and neurological diseases,and it spreads widely a-round the world.Since 2011,the newly emerged PRV variants have resulted in poor immunity pro-tection of traditional vaccine strains,and the original method of vaccine strain preparation is time-consuming and labor-intensive.Therefore,it is urgently needed to develop an efficient screening method of the vaccine strain at present.Using CRISPR/Cas9 gene editing technology in this study,two single guide RNAs(sgRNA)were designed targeting the virulence gene TK of PRV variant strain CH/JX/2016,and then the enhanced green fluorescent protein the reporter(EGFP)gene was inserted at the TK locus by a homologous repair plasmid.After multiple rounds of plaque puri-fication,the rPRV-ΔTK/EGFP strain was obtained.The results showed the cleavage efficiency of the two sgRNAs was extremely high.The preparation of rPRV-ΔTK/EGFP strain was succeed af-ter only three rounds of purification,and the EGFP expressed normally.The CRISPR/Cas9 system can edit the PRV gene simply,rapidly,and efficiently,and exhibits great potential in the construction of vaccine candidate strains.Meanwhile,the rescued rPRV-ΔTK/EGFP strain not only could be used as a tracer strain in PRV variant infection progresses,but also for subsequent antivi-ral drug screening.

Objective To investigate the current status of mini-CEX scores among students in the Elderly Service Man-agement program after completing the"Fundamentals of Nursing"course and analyze the influencing factors.Methods A total of 99 students from the Elderly Service Management program at the Wuming campus of Guangxi Medical University were selected as the study subjects.Assessment tools included a general information questionnaire,the Chinese version of the Mini Clinical E-valuation Exercise(mini-CEX),the Self-Rating Scale of Self-Directed Learning(SRSSDL),and a self-learning ability assess-ment scale.Stepwise linear regression analysis was employed to explore the factors affecting mini-CEX scores.Results The total mini-CEX score for the 99 students was 49.00(44.00,55.00).Stepwise linear regression analysis revealed that being a student leader,SRSSDL scores,self-learning ability,and teaching model were significant factors(P＜0.05),explaining 56.8％of the total variance.Conclusion The clinical comprehensive ability of students in the Elderly Service Management program requires enhancement,influenced by multiple factors including teaching model,self-learning ability,and self-directed learning capacity.

[Objective] To explore the characteristics of lifestyle behaviors and mental health status among blood donors in Guangzhou, and to investigate the correlation between donation frequency and these factors. [Methods] A cross-sectional study was conducted among 13 042 whole blood donors from 17 street blood donation sites of Guangzhou Blood Center from May to August 2020. Descriptive analysis was used to describe the characteristics of lifestyle behaviors and mental health status among blood donors in Guangzhou. Ordinal multinomial logistic regression model was used to analyze the correlation between donation frequency and these factors. [Results] It was found that some of 13 042 blood donors had unhealthy habits, such as 6.8% (698/10 214，2 828 missing values) had severe tobacco dependence, 30.6% (3 997/13 042) had low exercise levels, 38.8%（5 056/13 042）had poor sleep quality, and 2.2% (271/12 159，883 missing values) had alcohol dependence. In addition, 2.8% (364/13 042) and 1.3% (172/13 042) of the donors may have moderate to severe depression and anxiety symptoms, respectively. The results of the ordinal multinomial logistic regression model showed that exercise level was significantly negatively correlated with the degree of depression and anxiety among blood donors. With the decrease in exercise level, the possibility of depression and anxiety among donors increased significantly. BMI, household income, education level, marital status, donation frequency, alcohol consumption and smoking had no significant correlation with the mental health status of donors. [Conclusion] Improving the exercise habits of blood donors may help enhance their mental health level. It is recommended that blood station staff strengthen the content of exercise when providing health education to blood donors to maintain a healthy lifestyle. It also suggests that there may be a certain degree of under-diagnosis of mental health problems in the process of health consultation before blood donation, and conducting more comprehensive and effective mental health assessments for blood donors is recommended.

【Objective】 To investigate the prevalence of depression in blood donors and analyze the related factors, so as to develop a rapid depression screening model for blood donors. 【Methods】 A total of 13 015 street whole blood donors in Guangzhou Blood Center during May to August, 2020 filled in an anonymous e-questionnaire, including social demography information and the Patient Health Questionnaire-9 before donation. The cut-off value for detecting depression was 10. Logistic regression by SPSS 26.0 was used to analyze depression related factors. 2-level decision tree with 30/10 as the minimum number of cases in parent/child node, 10-fold cross validation was used to cut items of PHQ-9 to form the depression screening model. 【Results】 364 out of 13 015 (2.80%) street whole blood donors reported a score ≥ 10. Donors with 18-29 years old (P <0.05), unmarried (P<0.05), less than 50 000 RMB household income per year (P< 0.05) were more prone to depression. 81.96% donors in "<10 scores" group, while 3.85%donors in "≥ 10 scores" group were in two terminal nodes formed by Item-6, 2 and 4 of PHQ-9. After verification by the 10 fold crossover method, the estimated misclassification risk of the model was 1.7%. 【Conclusion】 The screening prevalence of depression based on PHQ-9 in Guangzhou blood donors was 2.8%(95% CI: 2.52%-3.09%) . Donation frequency was not related to depression. A rapid and efficient depression screening model for blood donors based on item-6, 2 and 4 of PHQ-9 was developed.

To improve the phenomenon of low participation and lack of innovation in education mode in general medical education elective courses, we have applied "creating significant learning experiences" to the design and implementation of medical general education curriculum, starting from six dimensions of learning including basic knowledge, application, synthesis, humanistic dimension, humanistic care, and learning to learn, setting learning goals, developing assessment tools and finally choosing teaching methods, thus forming a closed-loop teaching. And through the curriculum reform, collection of feedback and collation of data, the teaching activities designed according to this method fully meet and serve the teaching purposes, and assessment methods become more diverse and the content is more comprehensive, which reflects the multi-dimensional evaluation of the needs of general education.

Under the background of the innovative medical association, the company took the lead in promoting the senior nurses to the community hospitals in Anhui, and opened community nursing clinics to better implement the graded diagnosis and treatment system and meet the needs of residents' integrated health services. From the background of a new round of medical reform, this paper analyzes the new occupational orientation of senior nurses in the innovative medical association model, and introduces and analyzes the problems that arise in the exploration stage of the sinking community, and puts forward suggestions based on the actual situation.

Objective To explore the effects of "3+1+1" talent cultivation model on key competency in five-year higher vocational nursing students. Methods In March 2015, we selected five-year 80 higher vocational nursing students majoring in clinical nursing in 2013 of Wuxi Higher Health Vocational Technology School as subjects by convenience sampling. All of the 80 nursing students were divided into experimental group (n=38) and control group (n=42) according to classes. Nursing students of experimental group received the "3+1+1" talent cultivation model. Nursing students of control group were treated with the "4+1" cultivation model. The evaluation index system for key competency of five-year higher vocational nursing students was used to evaluated nursing students of two groups. We also compared the theoretical achievement and skills performance of nursing students between two groups. Results There were no statistical difference in key competency of nursing students between two groups at the end of the 2.5th school year (P＞0.05). The score of key competency of nursing students in experimental group was higher than that in control group at the end of the fourth school year with a significant difference (P＜ 0.05). There were no statistical differences in theoretical achievement and skills performance of nursing students between two groups at the end of the 2.5th school year (P＞0.05). The theoretical achievement and skills performance of nursing students in experimental group were higher than that in control group at the end of the fourth school year with significant differences (P＜ 0.05). Conclusions The "3+1+1" talent cultivation model can improve nursing students' key competency and school achievement.

Immune-checkpoint blockers(ICBs)have been well received in a variety of tumors,and the quality of patient life has improved significantly.However,the reasons why not all patients treated with ICBs benefit from lesion control,symptom improvement,and survival time.Many patients are resistant to the first time when they have been using ICBs for a period of time.This is a clinical challenge.This review lists possible causes of primary drug resistance and acquired resistance to ICBs.The primary resistance is associated with several mechanisms,including tumor microenvironment,cancer cells themselves and other related factors.The acquired resistance includes nonclassical immunoprecipitation molecules secondary overexpression,abnormalities of antigen presenting signal pathway and dysfunction of T cell activation killer.Finally,we have described a variety of possible new combination of treatment,including combined radiotherapy and chemotherapy,and combined targeted therapy with other measures.

Objective To discuss the efficancy of traditional Chinese medicine in treatment of intrahepatic cholestasis of pregnancy .Methods A total of 60 patients who were admitted to our hospital for severe intrahepatic cholestasis of pregnancy(ICP) from January 2009 to December 2012 were randomly divided into two group using random number table .Patients in study group (n=30) took traditional Chinese medicine three times a day plusUDCA twice a day orally .Patients in control Group (n=30)were on‐ly given UDCA twice a day orally .Conventional treatment and care for ICP were given to both groups .Biochemical index (TBA , ALT ,and AST)level ,pregnancy outcome and Caspase‐3 of the two groups were recorded and compared and compared .Results The expressing of Caspase‐3 in placental cytotrophoblast ,syncytiotrophoblast .Decidual cells and interstitial cells of study group were (10 .58 ± 2 .62)% ,(15 .8 ± 4 .02)% ,(10 .17 ± 3 .58)% ,(14 .23 ± 4 .39)% ,respectively ,which were significantly lower than those in control group(P<0 .05) ,which were (20 .46 ± 8 .68)% ,(33 .89 ± 7 .05)% ,(20 .56 ± 4 .23)% ,(28 .29 ± 5 .58)% .TBA ,ALT、AST in two groups were declined ,and ctedy group was better than in control group(P<0 .05) .The index of liver function were all lower in study group than that of control group(P<0 .05) .Incidence rate of neonatal asphyxia was lower in study group than that of con‐trol group (P<0 .05) .Conclusion Traditonal Chinese medicine can reduce the expression of Caspase‐3 in study group .It is safe and eflfective in the treatment of ICP .

Objective To investigate the effect of different puncture methods on dialysis adequacy in maintenance hemodialysis patients. Methods One hundred and twenty patients receiving maintenance hemodialysis were divided into the observation group and the control group according to the sequence of receiving the hemodialysis with 60 cases in each group. Patients in the observation group were treated with increasing distance arteriovenous fistula of more than 10 cm , while patients in the control group received normal dialysis care without changing the way of puncture. The difference of dialysis adequacy before and after intervention were compared between the two groups. Result The dialysis adequacy after intervention in the observation group was improved significantly compared with the control group (P<0.05). Conclusion The dialysis adequacy in patients with maintenance dialysis can be improved by increasing the puncture distance of internal arteriovenous fistula.