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Objective:To analyze the application value of PAD (Presentation-Assimilation-Discussion) class and case teaching combined with brainstorming in the practice teaching of nursing students in the department of cardiovascular surgery.Methods:A total of 81 undergraduate nursing students who practiced in the Department of Cardiovascular Surgery, The First Affiliated Hospital of Air Force Medical University from June 2019 to April 2020 were selected as the research objects. They were randomly divided into the control group ( n=40, brainstorming teaching) and the observation group ( n=41, PAD class combined with case teaching). After one month of intervention, the teaching effect on the two groups of nursing students were evaluated through the nursing students' clinical communication ability scale, Chinese version of self-assessment of clinical reflection and reasoning (SACRR), and competency inventory for registered nurse (CIRN). And the teaching quality was assessed by the clinical nursing teacher teaching behavior assessment scale. SPSS 22.0 was used for t-test. Results:The scores of each dimension and total scores of clinical communication ability scale, Chinese version SACRR and CIRN of nursing students in the observation group were higher than those in the control group ( P<0.05). The scores of nursing teaching behavior evaluation of clinical teachers in the observation group were higher than those in the control group ( P<0.05). Conclusion:The combination of PAD class and case teaching with brainstorming can improve the clinical communication ability of nursing students in cardiovascular surgery practice, help to promote the transformation of their clinical thinking ability, improve their core competences, and play an important role in improving the teaching quality.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Understanding the influence of mutations in the SARS-CoV-2 gene on clinical outcomes and related factors is critical for treatment and prevention. Here, we analyzed 209,551 high-coverage complete virus sequences and 321 RNA-seq samples to mine the mutations associated with clinical outcome in the SARS-CoV-2 genome. Several important hotspot variants were found to be associated with severe clinical outcomes. Q57H variant in ORF3a protein were found to be associated with higher mortality rate, and was high proportion in severe cases (39.36%) and 501Y.V2 strains (100%) but poorly proportional to asymptomatic cases (10.04%). T265I could change nsp2 structure and mitochondrial permeability, and evidently higher in severe cases (20.12%) and 501Y.V2 strains (100%) but lower in asymptomatic cases (1.43%). Additionally, R203K and G204R could decrease the flexibility and immunogenic property of N protein with high frequency among severe cases, VUI 202012/01 and 484K.V2 strains. Interestingly, the SARS-CoV-2 genome was more susceptible to mutation because of the high frequency of nt14408 mutation (which located in RNA polymerase) and the high expression levels of ADAR and APOBEC in severe clinical outcomes. In conclusion, several important mutation hotspots in the SARS-CoV-2 genome associated with clinical outcomes was found in our study, and that might correlate with different SARS-CoV-2 mortality rates.
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OBJECTIVE To analyze the reasons of ethylene oxide disinfection failure and give the countermeasures to guarantee the sterile quality.METHODS The investigation was carried out from the basic component of the whole disinfection,tracing and finding out the reasons of failure,and raising countermeasures.RESULTS Without meeting the sterile standards of the packages,incorrect packing method,without seriously checking and too much loading were the main failure reasons.CONCLUSIONS More education for the staff,good packing and education with the procedures of ethylene oxide disinfection are the key points to guarantee the sterile quality.
