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Objective@#To analyze the quality of final exam papers of Surgery and Field Surgery for five-year medical students from comprehensive class of Grade 2014, so as to check the mastery of different students, perfect the construction of item banking, verify the quality of teaching and learning, and thus provide references to further teaching reform.@*Methods@#SPSS 21.0 was used for statistical analysis of 133 Surgery and Field Surgery papers of students from comprehensive class of Grade 2014.@*Results@#The highest score was 93.5, the lowest score was 52.0, and the average score was (70.60±9.00). Among those 133 students, six students were failed, occupying 4.51%. The overall difficulty coefficient of examination paper (P) was 0.71, and P value of multiple choice questions and blank-filling questions was 0.4-0.7. Difference degrees (D) of question types were more than 0.600 and the overall reliability was 0.764. Scores of examination paper were generally in normal distribution. The average scores of students form anesthesiology major were higher than those of students from navigation medicine major, but the average scores of students from above two majors were higher than those of students from psychology major, with statistically significant differences (P<0.05).@*Conclusion@#Question types of this paper are comprehensive and reasonable. The overall difficulty is not high, the difference degree is good, the reliability is good and the score distribution is reasonable. However, the question should be further improved, focusing on the reasonable distribution of difficulty of question. In addition, we should strengthen the teaching of the course in students from psychology major.
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Objective To analyze the quality of final exam papers of Surgery and Field Surgery for five-year medical students from comprehensive class of Grade 2014, so as to check the mastery of different students, perfect the construction of item banking, verify the quality of teaching and learning, and thus provide references to further teaching reform. Methods SPSS 21.0 was used for statistical analysis of 133 Surgery and Field Surgery papers of students from comprehensive class of Grade 2014. Results The highest score was 93.5, the lowest score was 52.0, and the average score was (70.60 ±9.00). Among those 133 students, six students were failed, occupying 4.51％. The overall difficulty coefficient of examination paper (P) was 0.71, and P value of multiple choice questions and blank-filling questions was 0.4-0.7. Difference degrees (D) of question types were more than 0.600 and the overall reliability was 0.764. Scores of examination paper were generally in normal distribution. The average scores of students form anesthesiology major were higher than those of students from navigation medicine major, but the average scores of students from above two majors were higher than those of students from psychology major, with statistically significant differences (P<0.05). Conclusion Question types of this paper are comprehensive and reasonable. The overall difficulty is not high, the difference degree is good, the reliability is good and the score distribution is reasonable. However, the question should be further improved, focusing on the reasonable distribution of difficulty of question . In addition , we should strengthen the teaching of the course in students from psychology major.
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The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.
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The Surgery foundation is a course that emphasizes both theory and practice. It is an important part of surgical study and a compulsory basic course for medical students. The teaching quality of this course is directly related to the future level of clinical operation of medical students, and the good teaching methods and means are one of the key factors to determine the quality of the course. In this paper, the reform of teaching means and methods of this course are discussed, so as to further improve the teaching quality and summarize the experience and advice.
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Influenced by a variety of pathologic factors, cardiac fibroblasts can transdifferentiate into myofibroblasts and pro-liferate excessively, followed by an overdue secretion of extracellular matrix ( ECM) .This process involves complicated signaling path-ways and electrophysiological mechanisms and may result in atrial fibrosis and contribute to atrial remodeling in structure, function and electrophysiological signaling, which is considered as a most important phase of atrial fibrillation.This review focuses on the role of fi-broblasts in atrial fibrosis, atrial remodeling, and the development of atrial fibrillation.
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With the development of wireless networks and mobile intelligent terminal the new media technology is profoundly changing people's lifestyle and study mode. We applied new media technologies to the teaching practice of eight-year medical program to stimulate students' learning en-thusiasm and productivity, which greatly expanded the knowledge of students, enrich teaching methods, and achieved good teaching effect.
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Objective The protective effect of hydrogen sulfide (H2 S) against myocardial ischemia/reperfusion ( IR) injury via anti-apoptotic signaling is well established , but the underlying mechanism remains unclear .This study was to investigate whether H 2 S could protect cardiomyocytes from endoplasmic reticulum stress ( ERS)-mediated apoptosis in hypoxia/reoxygenation ( HR) injury by regulating the expression of microRNA-455 ( miR-455 ) . Methods Cardiomyocytes from neonatal SD rats were primarily cultured and the model of HR injury was established .The cardiomyocytes were divided into a control group (normally cultured for 27 hours), an HR group (subjected to HR injury), and an H2S protection group (pretreated with the precursor of H2S NaHS at 40 μmol/L at 30 min before HR treatment followed by the same procedure as in the HR group ) .The cell viability was monitored by MTT , the release of lactate de-hydrogenase ( LDH) in the culture supernatant measured by full-automatic chemical analysis , and the apoptosis rate of the cardiomyo-cytes detected by flow cytometry .The mRNA and protein expressions of Grp 78 and caspase-12 were determined by real-time RT-PCR and Western bot .To verify whether miR-455 was involved in the ERS-mediated apoptosis of the cardiomyocytes , the cells were subjec-ted to HR after transfected with miR-455 mimic or anti-miR-455 oligonucleotide (AMO) for 24 hours, followed by detection of the ex-pressions of Grp78 and caspase-12. Results After HR injury, the H2 S protection group showed an enhanced viability of the cardio-myocytes in comparison with the control group ([67.02 ±6.90] vs [29.27 ±5.66] %), an decreased LDH release ([91.33 ± 10.63] vs [168.17 ±15.38] U/L), and a reduced rate of cell apoptosis ([13.98 ±1.90] vs [24.31 ±2.79] %).H2 S pretreat-ment significantly downregulated the mRNA and protein expressions of Grp 78 and caspase-12 (1.66 ±0.39 vs 2.56 ±0.34;1.75 ± 0.32 vs 2.54 ±0.48;2.01 ±0.45 vs 3.26 ±0.34;1.85 ±0.52 vs 3.21 ±0.84, P<0.05).The mRNA and protein expressions of Grp78 and caspase-12 were evidently increased after transfection with miR-455 mimic (3.56 ±0.37 vs 1.00 ±0.00;3.61 ±0.41 vs 1.00 ±0.00;2.87 ±0.38 vs 1.00 ±0.00;2.98 ±0.49 vs 1.00 ±0.00), but remarkably decreased after transfection with miR-455 AMO (0.62 ±0.16 vs 1.00 ±0.00;0.65 ±0.13 vs 1.00 ±0.00;0.54 ±0.13 vs 1.00 ±0.00;0.62 ±0.16 vs 1.00 ±0.00, P<0.05). Conclusion H2S could protect cardiomyocytes from HR injury by regulating the expression of miR-455 and reducing ERS-mediated cell apoptosis .
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As a fundamental medical course,operative surgery is featured by basic skill acquirement and plenty of practice.The teaching method for operative surgery is different compared with that for other medical course.Personal digital assistant (PDA) was adopted to facilitate the teaching of the course and this was an innovation.By taking advantage of its multiple electronic functions and various application softwares,PDA was applied to arrange class schedule,show teaching demonstration,make action analysis and give feedback and incentives of both students and teachers.In this way,PDA was proved to be an effective educational media for teaching of operative surgery.
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Objective To investigate the surgical technique and clinical outcomes of reconstruction of the annulus and the intervalvular fibrous body during valve replacements. Methods Fifty-nine patients underwent reconstruction of the annulus or the intervalvular fibrous body during the valve replacement. Indications for the operation were small aortic annulus which may cause patient/prosthesis mismatch in 43, active infective endocarditis with the abscess in the periannulus tissue in 13, extensive calcification of the aortic annulus in 2 and an active bleeding complication of the aortic root after aortic and mitral valve replacement in 1. The reconstruction was done with fresh autologous pericardium. Results The aortic clamping time in reconstruction of the intervalvular fibrous body with double valve replacement was longer than that of the regular double valve replacement. Four patients died in the perioperative period, giving an overall in- hospital mortality of 6.7%. Postoperative complication were: re-sternotomy for bleeding in 2, Ⅲ degree A-V block in 2, respiratory dysfunction in 2, and acute renal failure in 2. Patients were followed up for 6 months by echocardiography study, and no periannular leakage was found. Conclusion Reconstruction of the annulus is an effective technique for patients with a small aortic annulus, extensive calcification of the interventricular fibrous body and active infective endocarditis with abscess. Although the operative procedure is challenging and taking more time, the technique is safe and reproducible.
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Objectives Postoperative atrial fibrillation (AF) has been associated with less favorable outcomes in patients undergoing coronary artery bypass graft surgery (CABG) and may result in increased post-operative morbidity and mortality. A systematic review and meta-analysis of published studies was conducted to examine the risk factors of occurrence AF after CABG. Methods Using the Medline database, the Cochrane clinical trials database and online clinical trial databases, we reviewed all randomized controlled trials (RCTs) and observational studies examining the risk factors of occurrence of AF after CABG. We searched for literature published April 2009 or earlier. Results Our review identified 8 studies (observational studies), involving 14548 patients, that examined the risk factors of occurrence of AF after CABG. Although studies provide conflicting results, the overall outcomes suggests that advanced age, previous hypertension, numbers of bridge vessels may increase the occurrence of AF after CABG, while no significant difference of diabetes, preoperative myocardial infarction, and preoperative medication of 13 -Blocker have been observed between the AF patients and no-AF patiens. Conclusions Patients with advanced age, previous hypertension and more numbers of bridge vessels had higher risk for the occurrence of AF after CABG, and perioperative medication and care must be intensified to decrease the postoperative occurrence of AF.
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BACKGROUND:When leucocytes were activated in the process of lung ischemia-reperfusion,various cell factors will be released,including tumor necrosis factor ?(TNF-?) and interleukin 1?(IL-1?),which lead to ischemia-reperfusion injury.Recent research demonstrates that transforming growth factor-?1 plays a protective role in ischemia-reperfusion injury after lung transplantation OBJECTIVE:To investigate the level changes of TNF-? and IL-1?after interfered with transforming growth factor-?1 after lung ischemic-reperfusion injury DESIGN,TIME AND SETTING:The randomized controlled experiment of animal was performed in the Cardiothoracic Surgery Laboratory of Changhai Hospital,Second Military Medical University of Chinese PLA from August to October 2007.MATERIALS:Thirty Sprague-Dawley rats with clean grade,were randomly divided into the sham operation,ischemia-reperfusion and transforming growth factor?1 groups,with 10 animal in each group.The transforming growth factor?1 was phuchased from Peprotech INC.METHODS:The left lung of rat in the ischemia-reperfusion and transforming growth factor?1 groups was prepared for to ischemia-reperfusion model by blocking pulmonary circulation with hilar vessels ligation for 60 minutes,followed by reperfusion for 2 hours.Animals in the sham operation group were crossed hilar with 10# silk thread.Heparin was administered intravenously through vena cervicalis at 15 minutes before ischemia in each group.Concurrently,10 ?g/kg transforming growth factor?1 was administered in transforming growth factor?1 group.MAIN OUTCOME MEASURES:After 2 hours of ischemia-reperfusion,the tissues of left lung were removed,histomorphological changes,wet-dry weight ratio,the index of histological lung injury and the content of TNF-?and IL-1?were determined by light microscope,enzyme-linked immunosorbent assay(ELISA),respectively.RESULTS:A total of 30 animals were enrolled in the result analysis.There was no obvious pathological change of lung in the sham operation group.Visible tissue edema and neutrophil infiltration could be found in the ischemia-reperfusion group,while,there was mild tissue edema and little neutrophil infiltration in the transforming growth factor?1 group.The wet-dry weight ratio and index of histological lung injury in the ischemia-reperfusion group was obvious greater than that of the sham operation group(P
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Physician-patient communication skill is the core clinical capability,and its im-portance is more and more recognized by educationists.Introducing the communication skill education into the standardized resident training can improve the residents'clinical and communicative ability and train them to be the comprehensive quality talents.
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To improve the quality of clinical teaching in burn surgery,79 students of Grade 2005 were randomly divided to problem-based learning(PBL)group and lecture-based learning(LBL) group.The teaching quality of two teaching methods were compared.The results showed that the average score,the score of teaching effectiveness appraisal targets in PBL group were sig-nificant higher than that in LBL group.This indicated that the teaching effectiveness of PBL was better than that of LBL,PBL should be applied in clinical teaching in burn surgery.
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To improve the quality of clinical teaching of plastic surgery for foreign students at different levels,we think that good teaching result will be got by applying English teaching for whole range,attaching importance to the selection and cultivation of the teaching staff,establishing individualized teaching program and compiling suitable material,and sticking to trial teaching before class,collective discussion and flexible teaching methods.
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One of the core tasks assigned to clinical teachers is to enable students to accurately assign a diagnostic label.The strengths and weaknesses of different approaches to clinical reasoning will be examined using one of the core divides between various models of analytic versus non-analytic as an orienting framework.Clinical teachers should stress the importance of both forms of reasoning,thereby enabling students to marshal reasoning processes in a flexible and context-specific manner.
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Problem-based learning is a student-centered teaching mode,which is based on creating question circumstances.In our clinical teaching,we put up questions based on real cases and inspire students'enthusiasm,activity and creativity.The results show the PBL can elevate students' clinical ability and also can promote teachers'capability.
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There are very close associations between spinal surgery teaching and medical imaging.Medical Imaging used in clinical medical teaching includes noumenal photograph,conceptual diagram,radiological imaging,operation photographic recording and computer-aided instruction courseware,etc.It is very important to collect the medical imaging through various means,set up medical imaging resources library for spinal surgery and use these resources in spinal surgery teaching.
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PBL teaching module is the developing trend of medical education reform in China.By studying the advanced foreign experiences and modern methods,teachers and students should change the perceptions and roles to adapt to the PBL teaching style in order to propel the reform of the medical education.
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"3+2" educational model was performed in our clinical medical college as a reformation based on traditional "4+1" model.After 5 years teaching practice,it obtained some good results as we prospected,however,there still exists some problems.This article analyzes the problems around the aspect of the teachers,the students,the teaching administration and arrangements,and proposes the corresponded measure to improve it.
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Objective To elucidate the effect of ischemic preconditioning(IPC)on regional fluidity of myocardial cell membrane during cardiopulmonary bypass (CPB). Methods Seventy-five felines were randomized into three groups: Group A (CPB group,n =25),in which CPB was conducted without aortic cross-clamping (ACC);Group B (IR group,n =25),with 60min ACC followed by 60min reperfusion,and cardioplegia used during period of ACC;Group C (IPC group,n =25),with protocol similar to that of group B except for three-cycle IPC applied before ACC. Electron spin resonance (ESR) technique was employed to monitor membrane regional fluidity of cardiomyocyte during CPB in all groups. Results Regional fluidity of myocardial cell membrane kept unchanged in CPB group and markedly decreased during ACC and reperfusion periods in IR group. Though the regional fluidity of myocardial cell membrane during ACC and reperfusion periods in IPC group was slightly decreased compared to CPB group,it was significantly higher than that in IR group. Conlusion IPC can protect myocardial cells from ischemia and reperfusion injury by maintaining the fluidity of myocardial membrane during CPB.