Objective:To explore the impact of defective case introduction teaching combining virtual and real elements on the enhancement of competence among orthopedic nursing interns.Methods:Ninety-six nursing students serving as interns in the Department of Orthopedics from March to September 2023 were selected and randomly assigned to either observation group or control group using a random number table, with 48 students in each group. The control group received conventional teaching, while the observation group received defective case introduction teaching combining virtual and real elements. The two groups were compared for the changes in assessment scores, self-learning ability, core skills, decision-making ability, and critical thinking following completion of internship. Statistical analyses were performed using the t-test and chi-square test via SPSS 23.0. Results:At the conclusion of the internship, both groups showed improvements in their theoretical knowledge and practical skills, self-learning ability scores, Competency Inventory for Registered Nurse (CIRN) scores, Clinical Decision-Making in Nursing Scale (CDMNS) scores, and Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) scores. Notably, the improvements were significantly greater in the observation group than in the control group ( t=2.64, 2.30, 3.44, 26.52, 10.87, P<0.05). Conclusions:The application of defective case introduction teaching combining virtual and real elements can enhance the self-learning and core competence of orthopedic nursing interns.

Objective:To explore the impact of defective case introduction teaching combining virtual and real elements on the enhancement of competence among orthopedic nursing interns.Methods:Ninety-six nursing students serving as interns in the Department of Orthopedics from March to September 2023 were selected and randomly assigned to either observation group or control group using a random number table, with 48 students in each group. The control group received conventional teaching, while the observation group received defective case introduction teaching combining virtual and real elements. The two groups were compared for the changes in assessment scores, self-learning ability, core skills, decision-making ability, and critical thinking following completion of internship. Statistical analyses were performed using the t-test and chi-square test via SPSS 23.0. Results:At the conclusion of the internship, both groups showed improvements in their theoretical knowledge and practical skills, self-learning ability scores, Competency Inventory for Registered Nurse (CIRN) scores, Clinical Decision-Making in Nursing Scale (CDMNS) scores, and Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) scores. Notably, the improvements were significantly greater in the observation group than in the control group ( t=2.64, 2.30, 3.44, 26.52, 10.87, P<0.05). Conclusions:The application of defective case introduction teaching combining virtual and real elements can enhance the self-learning and core competence of orthopedic nursing interns.

Objective To investigate the drug resistance and its distribution induced by β-lactamases and class Ⅰ integrons with the deficiency of Omp genes in Enterobacter cloacaes.Methods Totally 112 strains of Enterobacter cloacaes were isolated during January 2008 and May 2011.The identification of strains was performed by using Vitek-2 Compact automatic system; and antibiotic susceptibility was determined by K-B method.Isolates of E.cloacae were screened for carbapenemases by modified Hodge test,improved three dimensional test and EDTA-meropenem synergy test.Genes encoding AmpC β-lactamase,metallo-β-1actamases (MBLs) and OXA-like β-1actamases were screened by multiple PCR.Single PCR was used to detect ISEcpl,OmpK35/36,NDM-1 and OXA-48.The variable regions of class Ⅰ integrons were amplified and sequenced.Results Among 112 isolates,6 (5.4％) demonstrated positive in the modified Hodge test and 14 ( 12.5％ ) were positive in the improved three-dimensional test.No carbapenemases gene was found.There were 29(25.9％ ) strains positive for ESBLs genes,ISEcpl was found in the upstream of all the CTX-M-type ESBLs; OXA-1 ESBLs were detected in 2 isolates.AmpC β-lactamase genes were positive in 45 (40.2％) strains,and 82.2％ (37/45) were MIR-3 type.Twenty two isolates carried class Ⅰ integrons,and four different cassettes arrangements were identified within 16 strains:9 isolates harbored aadB-aadA2 ( 1 000 bp),5 isolates with dfrAl5 (700 bp),2 isolates with aadAl ( 1 000 bp).One isolate harbored all the above gene cassettes.The deficiency of OmpK35/36 was found in all strains.Conclusion ESBL,AmpC β-lactamase and the deficiency of OmpK35/36 are correlated with the resistance to carbapenems in Enteobacter clocace,and class Ⅰ integrons may also partly account for the multidrug-resistance.

Directed evolution was used to improve the performance of beta-1,3-1,4-glucanase (designated as PtLicl6A) from Paecilomyces thermophila J18 under acidic condition. A mutant library was constructed by error-prone PCR and DNA shuffling, and positive clones were screened by Congo red staining. More than 1 500 mutants were selected. One mutant (PtLic16AM1) exhibited an optimal activity at pH 5.5, while the optimal pH of the wild-type enzyme was 7.0. The mutant PtLic16AM1 kept the high specific activity and thermotolerence of the wild-type enzyme. Sequence analysis revealed that the mutant enzyme has four sense substitutions which caused four amino acid substitutions - namely T58S, Y110N, G195E and D221G.. Homology modeling showed that among the four amino acid substitutions, Y110N was near the active site of the enzyme, while the other three was distant. T58S and G195E may play key roles in the change of optimal pH. This study provided a new perspective of obtaining applicable 3-1,3-1,4-glucanase for industrial use.
Catalysis ; Directed Molecular Evolution ; methods ; Endo-1,3(4)-beta-Glucanase ; biosynthesis ; genetics ; metabolism ; Enzyme Stability ; Hot Temperature ; Hydrogen-Ion Concentration ; Mutant Proteins ; metabolism ; Mutation ; Paecilomyces ; classification ; enzymology ; genetics ; Protein Engineering ; methods