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This article summarizes the experience in the teaching model of flipped classroom combined with group learning in the course of biostatistics in Duke University and discusses the application of this teaching model in universities and colleges in China.The study results show that this teaching model introduces group learning in flipped classroom to develop continuous peer-assisted learning.Meanwhile,this teaching model follows the process of knowledge internalization and designs four successive steps of individual readiness assessment,team readiness assessment,mini-lectures,and application activity,in order to strengthen the understanding and practical application of key points.This teaching model also establishes a transparent mechanism for individual and curriculum evaluation and feedback collection to find and solve the issues in this course.These teaching experiences provide a good reference for the application of flipped classroom in large-class teaching in China.
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Objective To intervene and appraise the health literacy of diabetic patients entering contracts with family doctors in pilot communities,and learn the effect and feasibility of health literacy management by family doctors for diabetic patients.Methods By means of community intervention study and questionnaire survey,560 diabetic patients as mentioned above in Shanghai were subject to a baseline assessment on their health literacy,followed by management and routine follow-up on their diabetic health literacy.At the end of six months of comprehensive intervention,their health literacy was appraised again to observe the effects of such management.Results Six months of guidance and management found the average scoring of the health literacy of these patients 23.46 over the baseline,an increase of 36.8% of the patients in their compliance of the four basic diabetic diet behaviors,and an increase of 27.8% of them in regular and quantitative exercises.Conclusions It is feasible for community family doctors to carry out the health literacy management for diabetic patients contracted,and health literacy management can change the awareness and behaviors of such patients to some extent.
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An electronic medical record(EMR)system is built at urban community health centers to optimize services,achieving information integration of outpatient medical services based on the doctors' workstation.This system has optimized service at the outpatient clinics in the following:1.Digitizing service processes for higher efficiency and service quality; 2.Using EMR templates to save doctors' time in writing medical records for more of their time in patient inquiries and checks; 3.Using LIS,PACs and ECG/EKC systems to check lab results and imaging diagnostics of patients; 4.Using the diagnostic and therapy record sub-system to check electronic records of the patients for consulting their health history;5.Using the Shanghai Medical Alliance's(SMA)shared sub-system to acquire patients' medical records at SMA medical institutions,learning their conditions for their therapies.EMR,when it is built and put into use,can help improve GP's diagnostics and therapeutics,and provide better care to the outpatients as well.
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Objective To investigate renal expression of ApoE in human lupus nephritis (LN) and its relationship with renal damages.Methods Renal expression of ApoE was examined in 40 LN patient biopsy samples by immunohistochemieal staining.The relationship between ApoE levels" and renal pathologic changes,renal injuries was analyzed.Results Only weak ApoE expression was found in normal renal tissue.The expression of ApoE was significantly higher in LN patients [ glomerular:(31.2±11.0) vs (3.0±1.6);tub-ular:(71.64±8.90) vs (0.60±0.06)].The expression of ApoE was higher in class IV than non-class IV LN [glomerular: (38.4±4.5) vs (18.0±4.6);tubular: (77.6±2.5) vs (60.0±3.2)].Spearman's relation-ship analysis showed that the expression of ApoE in glomerular and tubular was closely related to the renal histological score activity index and functional changes in LN (P＜0.01).Conclusion The expression of ApoE is high in renal tissues of LN,especially in class IV,and the high expression may be associated with LN activity and progressive renal dysfunction.
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Objective To study the changes of quantitative expression,adhering activity and genomic density polymorphism of complement type 1 in erythrocytes (CR1) of patients with liver cancer (104 patients) and their clinical significance.Methods Polymerase chain reaction (PCR),HindIII restriction enzyme digestion,the quantitative assay of ECR1 and the adhering activity assay of CR1 in erythrocytes were used.Results No difference was observed between the patients with liver cancer (29.8%) and healthy individuals (25.3%) in the spot mutation rate of CR1 density gene (χ2 =0.537,P>0.05).The number and the adhering activity of CR1 in patients with liver cancer (0.83±0.22 and 47.1±6.5) were significantly lower than those in healthy individuals (1.26±0.33 and 62.4±7.6; t=10.5,P<0.0001).The number and the adhering activity of ECR1 in high expression genomic type (HH) liver cancer were obviously lower than those of healthy individuals,expecially those of the patients with advanced liver cancer.There was a good relationship between quantitative expression,adhering activity of ECR1 and liver cancer development.Conclusion Defective expression of CR1 in liver cancer is mostly acquired through central peripheral mechanisms.The changes of CR1 quantitative expression and adhering activity are consanguineously related to the severity and the activity of the development in patients with liver cancer.