Through serial problem-oriented teaching method(S-PBL),problem based learning-case-based-case based learn-ing(PBL-CBL)comprehensive teaching method,industry-university-research case integration teaching,cutting-edge literature review and other teaching methods,students'attention to learning immunology knowledge is grasped and students'learning efficiency is im-proved;combined with immunology experiment,enhance students'understanding of classroom teaching content;through professional practice,strengthen students'understanding of the development process,production process and market demand of immune products,and enhance students'interest and initiative in learning and consolidating immunology knowledge;through the introduction of major research achievements such as the Nobel Prize in immunology,students'interest and motivation in exploring innovative content in the field of immunology research will be cultivated.Through the above teaching reform,we will cultivate a new generation of biological people who have a solid knowledge of immunology,have the potential to develop immune products,have the sense of innovation and entrepreneurship,and have responsibility and responsibility.

Familial glucocorticoid deficiency type 4(FGD4) is a rare autosomal recessive disorder caused by mutations in the nicotinamide nucleotide transhydrogenase(NNT) gene. The article presented clinical data, laboratory results, and genetic mutation findings of a child with FGD4. Additionally, a retrospective analysis of the clinical data of FGD4 patients reported domestically and internationally was conducted, summarizing the types of gene mutations and clinical characteristics. This case identifies novel mutation sites in the NNT gene, providing a basis for the early diagnosis and treatment of FGD4 patients.

Objective:To explore the effect of combining hand-brain perception training with hand-brain motor training based on mirror neuron theory on the recovery of upper limb function after a stroke.Methods:A group of 105 stroke survivors with upper limb dysfunction were randomly divided into a hand-brain perception (HP) group, a hand-brain motor (HM) group, and a combination (C) group, each of 35. In addition to conventional rehabilitation treatment (including exercise therapy, occupational therapy and physical factor therapy), the HP and HM groups were given hand-brain perception training and hand-brain motor training respectively, while group C was provided with both. Before the intervention and after 4 weeks, the upper limb motor functioning of all of the participants was assessed using the simplified version of the Fugl-Meyer upper limb motor function scale (FMA-UE). Sensory functioning was quantified using the tactile Semmes Weinstein monofilament examination (SWME), and the modified Barthel index (MBI) was used to quantify the participants′ ability in the activities of daily living.Results:After the intervention the average FMA-UE, MBI and SWME scores of all three groups had improved significantly, with group C′s average FMA-UE and MBI scores significantly better than the other two groups′ averages. The average SWME score of group C was then significantly better than that of group HM.Conclusions:Hand-brain perception combined with hand-brain motor training based on mirror neuron theory can further promote the recovery of upper limb sensory and motor functioning of stroke survivors., Such therapy is worthy of clinical promotion and application.

The epidemic of COVID-19 has become the topmost public health threat worldwide. The authors suggested that in addition to strengthening the organization and leadership of the abovementioned work, greater attention be paid to establishing and improving the prevention and control mechanism.Furthermore, special efforts should be given to the safety of the medical workers, by strengthening their infection monitoring and outbreak management. Medical workers in different work areas and positions should be placed under careful protection with due cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. Such special issues in the management of pediatric patients, as allocation of nurses, the screening and management of caregivers, the problem of breastfeeding, and the disinfection of children′s toys and diapers were discussed. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments, which aim to guide the prevention and control of COVID-19 nosocomial infection in the pediatric outpatient and ward.

The pneumonia caused by the novel coronavirus (2019-nCoV), which began in December 2019, has become the most serious public health problem, threatening people's health and life. This threat is posing a severe challenge on the diagnosis and treatment of 2019-nCoV infection, the prevention and control of hospital cross infection of medical staff. It is suggested that in addition to strengthening the organization and leadership of the abovementioned work, establishing and improving the prevention and control mechanism deserve greater attention. Furthermore, special attention should be given to the safety of the medical staff, strengthening their infection monitoring and outbreak management. Medical staff in different work areas and positions should be placed under careful protection, cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments. These measures are proposed to provide a guidance for the prevention and control of 2019-nCoV nosocomial infection in the pediatric outpatient and ward.

Objective: To study the application value of improved early warning score in the practice of theory and practice interactive infiltration training mode for neurosurgery interns. Methods: A total of 84 neurosurgery interns were selected as study samples and randomly divided into control group and intervention group by random double blind method, each group had 42 interns. The control group adopted the interactive infiltration model of theory and practice. The Intervention group adopted the interactive infiltration training mode of theory and practice under the improved early warning scoring system design. Statistics and comparison of the performance of the two groups of trainee nurses, the evaluation of teaching teachers and patients, the self-evaluation of trainee nurses, and the occurrence of nursing errors during the internship. Results: The related examination results between the two groups showed significance (t value was 7.182,5.462,5.530, P<0.01). The evaluation for nursing students by teachers and patients also showed significant difference (t value was 6.989-8.790, P<0.01). The incidence of error event in the intervention group was 9.52% (4/42), lower than that in the control group [30.95% (13/42)]. There was statistical difference between two groups (χ² value was 14.227, P<0.01). Conclusions The application of the improved early warning score in the theory and practice interactive infiltration training mode of neurosurgery interns can improve the satisfaction of teachers and patients to interns, enhance the self-satisfaction of interns and reduce the incidence of nursing errors of interns.

Objective:To explore the effects of 5E rehabilitation nursing model on self-management behavior and fatigue symptoms of patients with chronic obstructive pulmonary disease (COPD) .Methods:Totally 110 COPD patients admitted in Yantai Yuhuangding Hospital from October 2018 to September 2019 were selected by convenient sampling, and divided into the control group ( n=53) and the experimental group ( n=57) according to the random number table. Excluding missing patients and patients with incomplete data, finally 48 patients were included in the control group and 51 patients were included in the experimental group. Patients in the control group received routine care and health guidance, while patients in the experimental group received care based on the 5E rehabilitation nursing model. The Self-Management Scale for COPD Patients and the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F) were used to evaluate the effects of interventions in the two groups. Results:There was no statistically significant difference in the scores of the Self-Management Scale between the two groups before intervention ( P>0.05) ; the scores of all dimensions the Self-Management Scale of the experimental group were higher than those of the control group 12 weeks after discharge, and the differences were statistically significant ( P<0.05) . There was no statistically significant difference in fatigue scores between the two groups before intervention and 12 weeks after discharge ( P>0.05) . Conclusions:The 5E rehabilitation nursing model can improve the self-management behavior of COPD patients, but it cannot ameliorate the fatigue symptoms of patients. Large-sample, multi-center, and long-term research will be further needed in the future to explore the effects of the 5E rehabilitation nursing model on patients' fatigue symptoms.

Objective: To investigate the mechanisms of miR-375 affecting the proliferation and invasion of hepatoma cells via targeting YAP (Yes-associated protein). Methods: The cancerous tissues and corresponding para-cancerous tissues of 70 patients with hepatocellular carcinoma (HCC) who underwent surgical resection at the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2015 to December 2016, as well as the hepatoma cell lines SMMC-7721, Hb611, HepG2 and BEL-7405 were collected for this study. qPCR method was used to detect the expression level of miR-375 in collected HCC tissues and different hepatoma cell lines; Dual luciferase reporter gene assay was used to verify the interaction between miR-375 and YAP; The relationship between miR-375 and clinicopathological features of HCC patients was also analyzed; MTT assay was used to detect the effect of miR375 on the proliferation of hepatoma cells; Transwell invasion assay was used to detect the invasive ability of hepatoma cells after inhibiting the expression of miR-375; Western blotting was used to detect the expression of YAP in HepG2 cells. The nude mouse model of subcutaneously transplanted xenograft was established, and the tumor volume and mass of transplanted hepatoma cells were detected after inhibiting the expression of miR-375. The expression of YAP in xenograft of nude mice was detected by immunohistochemistry and Western blotting. Results: The expression of miR-375 and YAP in HCC tissues was significantly higher than that in para-cancerous tissues (all P<0.05). The expression of miR-375 in HepG2 cells was the highest (P<0.05). miR-375 could specifically bind to the 3' UTR of YAP and regulate the expression activity of YAP. After inhibiting the expression of miR-375, the proliferation and invasion abilities of HepG2 cells were reduced (all P<0.05); The tumor volume and mass of transplanted xenografts were significantly reduced (both P<0.05); The expression of YAP protein in the transplanted xenografts was down-regulated (P<0.05). Conclusion: miR-375 plays an important role in the occurrence and development of liver cancer, and can influence the malignant biological behaviors of hepatoma cells by targeting and regulating the expression ofYAP.

Objective To investigate the clinical manifestations,laboratory tests,and image modalities on rheumatoid arthritis (RA) accompanied with atlanto-axial joint involvement.Methods Sixty-four cases of RA accompanied with cervical vertebra involvement were divided into 2groups by lesion location.Twenty-two cases were RA accompanied with atlanto-axial joint involvement,while 42 cases were RA with cervical vertebra other than atlanto-axial joint involvement.The age,course,clinical manifestations and the lab results were compared between the two groups by t test,Chi-square test and Fisher's exact probability.The X-ray,CT and magnetic resonance imaging (MRI) for cervical vertebra were analyzed in RA with atlanto-axial joint involvement.Results Compared with non-atlantoaxial cervical group,the disease course [(15±10) years vs (8±9) years,t=3.030,P=0.004],upper cervical vertebra pain (73％ vs 7％,x2=29.75,P＜0.01),lower cervical vertebra pain (9％ vs 40％,x2=6.813,P=0.009),cervical activity limitation (68％ vs 14％,x2=19.023,P＜0.01),upper cervical vertebra pressing pain (100％ vs 7％,22=52.297,P＜0.01),lower cervical vertebra pressing pain (9％ vs 60％,x 2=15.056,P＜0.01) and erythrocyte sedimentation rate (ESR) [(73±34) mm/1 h vs (53±37) am/1 h,t=2.039,P=0.046)] were significantly different in atlantoaxial joint lesions group.CT combined with MRI exams had high diagnostic..value in RA with atlanto-axial joint involvement.CT scan had the conformed diagnostic value.Sixteen cases were positive (73％) by MRI scan,while 3 cases (14％) by X-ray.Conclusion Timely CT scan and/or MRI scan for RA patients with neck pain in upper cervical vertebra,long disease course,cervical activity limitation and high ESR are helpful for early diagnosis of atlanto-axial joint involvement.

Objective To explore the mediating effect of organizational commitment on the relationship between perceived professional benefit and turnover intention among clinical nurses. Methods A total of 456 nurses from 3 hospitals in Hangzhou were investigated with Occupational Benefit Questionnaire,Organizational Commitment Scale and Turnover Intention Scale. Results The score of perceived professional benefit, organizational commitment and turnover intention were(135.41 ± 19.01), (16.10 ± 2.87),(76.28 ± 15.80) respectively. Pearson correlation analysis showed that there was a significant positive correlation between perceived professional benefit and organizational commitment(r=0.476, P<0.01),and a significant negative correlation to turnover intention(r=-0.313, P<0.01),and a significant negative correlation between organizational commitment and turnover intention(r=-0.525, P<0.01).Organizational commitment played a partial mediating effect between perceived professional benefit and turnover intention among nurses. Conclusions Nursing managers should attach an importance to enhance organizational commitment,and take effective measures to improve perceived professional benefit, as well as establish an effective incentive mechanism, fully mobilize positive factors to reduce the nurses ' turnover rate and stable the nursing team.