Una educación para la vida: resignificación de proyectos educativos integrales / integralesAn Education for Life: Re-meaning of Integral Education ProjectsUma / Uma educação para a vida: ressignificação de projetos educativos complementares

El proyecto de resignificación educativa busca la forma-ción permanente del docente que piensa en la educación como proceso, para transformar el espacio educativo tradicional en un espacio democrático y participativo, con proyectos cooperativos e interdisciplinarios. Duran-te seis meses se trabajó desde la Investigación Acción Educativa (iae) (Elliot, 1998), por lo que los temas del programa se establecieron de acuerdo con los intereses y necesidades de los profesores y directores de la escuela. La implementación se realizó con la comunidad edu-cativa de una institución rural de São Paulo, en la cual se desarrollaron talleres semanales alrededor de las preguntas: ¿Cuáles serían las propuestas de trabajo di-recto con los estudiantes?, ¿qué cambios afectarían las concepciones y prácticas pedagógicas de los maestros y las relaciones entre todos los miembros de la comuni-dad escolar (estudiantes, maestros, empleados, familia, etc.)? Con los 217 estudiantes, de 4 a 11 años de esta institución, se trabajaron guiones de estudio basados en sus intereses. Los resultados preliminares de estos proyectos han demostrado que es posible construir la educación para la ciudadanía y la conciencia ambiental a través de acciones que tengan sentido para la comu-nidad escolar

The Educational Resignification Project seeks the per-manent training of the teacher who thinks of education as a process, to transform the traditional educational space into a democratic and participatory space, with cooperative and interdisciplinary projects. Work was carried out for six months using the Educational Action Research-iae (Elliot, 1998); therefore, the topics of the program were established according to the interests and needs of the teachers and school directors. The implemen-tation was conducted with the educational community of a rural institution in São Paulo, where weekly workshops were developed around the questions: What would be the proposals for direct work with students? and What changes would affect pedagogical conceptions and practices of teachers and the relationships between all members of the school community (students, teachers, employees, family, etc.)? With the 217 students from 04 to 11 years old at this school, study scripts were developed based on their interests. The preliminary projects' results showed it is possible to build education for citizenship and environmental awareness through actions that make sense for the school community.

O Projeto de Ressignificação Educacional busca a for-mação permanente do professor que pensa a educação como um processo, para transformar o espaço educa-cional tradicional em um espaço democrático e partici-pativo, com projetos cooperativos e interdisciplinares. Trabalhamos por seis meses a partir da Pesquisa-Ação Educacional (pae) (Elliot, 1998), de modo que os te-mas do programa foram estabelecidos de acordo com os interesses e necessidades dos professores e direto-res escolares. A implementação foi realizada com a comunidade educativa de uma instituição rural de São Paulo, onde foram desenvolvidas oficinas semanais em torno das questões: "Quais seriam as propostas de tra-balho direto com os alunos?"; "Que mudanças afetariam as concepções e práticas pedagógicas dos professores e as relações entre todos os membros da comunidade escolar (alunos, professores, funcionários, família, etc.)?". Com os 217 alunos de 04 a 11 anos desta escola, foram trabalhados roteiros de estudo baseados em seus in-teresses. Os resultados preliminares desses projetos mostraram que é possível construir educação para a cidadania e consciência ambiental por meio de ações que façam sentido para a comunidade escolar.

Construção e validação de tecnologia educacional para promoção de saúde bucal da gestante na estratégia saúde da família / Construction and validation of educational technology to promote pregnant oral health in the family health strategy / Construcción y validación de tecnología educativa para promover la salud bucal de la gestante en la estrategia de salud familiar

Objetivo: Este estudo teve como objetivo construir e validar um pacote de mensagens de texto e figuras para promoção de saúde bucal da gestante. Métodos: Estudo metodológico, realizado em quatro etapas: revisão da literatura, construção de pacote de mensagens e figuras, qualificação pelo público-alvo e validação de conteúdo e aparência. Para validação, participaram 19 especialistas odontólogos na estratégia saúde da família. O critério para validação foi concordância superior a 80%, analisada por meio dos índices de validação de conteúdo e aparência. Resultados: a versão final do pacote de mensagens e figuras apresentou índice de validade de conteúdo por especialistas de 0,82, índice de validade de aparência de 0,93, razão de validade conteúdo de 0,56 e um índice de concordância de 0,81. Conclusões e implicações para a prática: o pacote de mensagens de textos e figuras foi considerado válido em conteúdo e aparência para promoção de saúde bucal da gestante, constituindo tecnologia educacional adequada para ser compartilhada via mensagens pelo aplicativo WhatsApp, demonstrando qualidade e potencial para ser efetivo no cuidado à saúde bucal das gestantes da estratégia saúde da família.

Objective: This study aimed to build and validate a package of text messages and pictures to promote pregnant women's oral health. Methods: this was a methodological study, conducted in four stages: narrative and integrative literature review, construction of a message and picture package, readability analysis, and content and appearance validation. For validation, 19 judges with expertise in dentistry in the family health strategy participated. The criterion for validation was agreement greater than 80%, analyzed using the content and appearance validation indexes. Results: the last version of the message and picture package had an expert content validity index of 0.82, an appearance validity index of 0.93, a content validity ratio of 0.56 and an 81% agreement index. Conclusions and implications for practice: the message package of texts and pictures was considered valid in terms of content and appearance for promoting the pregnant woman's oral health, constituting an appropriate educational technology to be shared via telephone messages, demonstrating quality and potential to be effective in care to the oral health of pregnant women in the family health strategy in Fortaleza.

Objetivo: Este estudio tuvo como objetivo construir y validar un paquete de mensajes de texto e imágenes para promover la salud bucal de las gestantes. Métodos: se trató de un estudio metodológico, realizado en cuatro etapas: revisión bibliográfica narrativa e integradora, construcción de un paquete de mensajes e imágenes, análisis de legibilidad y validación de contenido y apariencia. Para la validación, participaron 19 jueces expertos en odontología en la estrategia de salud familiar. El criterio de validación fue un acuerdo superior al 80%, analizado mediante los índices de validación de conte- nido y apariencia. Resultados: la última versión del paquete de mensajes e imágenes tuvo un índice de validez de contenido por expertos de 0,82, un índice de validez de apariencia de 0,93, un índice de validez de contenido de 0,56 y un índice de acuerdo del 81%. Con- clusiones e implicaciones para la práctica: el paquete de mensajes de textos e imágenes fue considerado válido en términos de contenido y apariencia para la promoción de la salud bucal de la gestante, constituyendo una tecnología educativa adecuada para ser com- partida a través de mensajes telefónicos, demostrando calidad y potencial para ser eficaz en la atención a la salud bucal de la gestante en la estrategia de salud familiar en Fortaleza. PALABRAS CLAVE: Salud Bucal; Embarazadas; Promoción de la Salud; Tecnologías Educativas.

Association between axial length and level of education in elderly patients with cataracts unexposed to electronic devices in the first two decades of life / Associação entre diâmetro axial e nível educacional em pacientes idosos com catarata não expostos a dispositivos eletrônicos nas duas primeiras décadas de vida

ABSTRACT Purpose: To determine whether the axial length is associated with the education level in elderly patients with cataracts who were not exposed to electronic devices in the first two decades of life. Methods: This cross-sectional study was conducted in elderly patients with cataracts in Campinas, Brazil. Patients were divided into 2 groups: Group 1 included those who completed, at most, elementary school (including the illiterate and those who partially or totally attended elementary school), which corresponded to 12 years of schooling; Group 2 included, at least, high school graduates (including those who completed high school and those who partially or fully attended university). The sample was selected randomly with stratification for sex and age. The main outcome was the axial length. Results: The sample consisted of 472 elderly patients (236 per group) who underwent cataract surgery. There were 272 (57.6%) men and 200 (42.4%) women; the distribution was symmetrical between the two groups. The median age (IQR; range) was 66 (12; 50-89) years. The median axial length (IQR; range) was 22.82 (1.51; 20.34-28.71) mm in Group 1 and 23.32 (1.45; 20.51-31.34) mm in Group 2 (p<0.001). Conclusion: A greater axial length was associated with a higher level of education in elderly patients with cataracts, suggesting that myopization is related to an increase in activities requiring near-vision even before exposure to electronic devices.

RESUMO Objetivo: Determinar se o diâmetro axial está asso­ciado ao nível educacional em pacientes idosos com catarata que não foram expostos a dispositivos eletrônicos nas duas primeiras décadas de vida. Métodos: Este estudo transversal foi conduzido em pacientes idosos com catarata na cidade de Campinas, Brasil. Os Pacientes foram divididos em 2 grupos: no Grupo 1 foram incluídos aqueles que completaram, pelo menos, o ensino fundamental (incluindo analfabetos e aqueles com ensino fundamental completo ou incompleto), o que corresponde a 12 anos de escolaridade; no Grupo 2 foram incluídos indivíduos que, pelo menos, estudaram até o ensino médio (incluindo indivíduos com ensino médio completo e superior completo ou superior incompleto). A amostra foi selecionada aleatoriamente com estratificação por sexo e idade. O desfecho principal foi a medida do diâmetro axial. Resultados: A amostra foi constituída por 472 indivíduos que foram submetidos a cirurgia de catarata. Duzentos e trinta e seis indivíduos (50%) foram alocados no Grupo 1 e duzentos e trinta e seis indivíduos (50%) no Grupo 2. A mediana da idade (IIQ; intervalo) foi 66 (12; 50-89) anos. Duzentos e setenta e dois (57,6%) eram homens e duzentos (42,4%) mulheres, com distribuição simétrica entre os dois grupos. A mediana do diâmetro axial (IIQ; intervalo) foi 22,82 (1,51; 20,34-28,71) mm no Grupo 1 e 23,32 (1,45; 20,51-31,34) mm no Grupo 2 (p<0,001). Conclusão: Maiores medidas de diâmetro axial foram asso­ciadas a níveis educacionais mais elevados em pacientes idosos submetidos a cirurgia de catarata. Tal achado sugere que a miopização relacionada ao aumento de atividades que utilizam a visão de perto é fenômeno que ocorre antes mesmo da exposição a dispositivos eletrônicos.

Edutainment and Social Mobilization in the Prevention of Gender-Based Violence in Adolescents: Findings on the role of dialogue, Debate, and Reflection in a Pilot Strategy of "Revelados" in a Colombian Caribbean Municipality / Edu-entretenimiento y movilización social en la prevención de las violencias basadas en género en adolescentes: hallazgos sobre el rol del diálogo, el debate y la reflexión en un piloto de "revelados" en un municipio del caribe colombiano

RESUMEN Este artículo aborda el proceso de generación de diálogo, debate y reflexión sobre Violencias Basadas en Género (VBG) en adolescentes del municipio de San Juan Nepomuceno (Bolívar), en el marco de la realización de un piloto de la estrategia de edu-entretenimiento y Movilización Social "Revelados desde todas las posiciones", implementada en varios municipios de Colombia. A través de grupos focales, entrevistas y la técnica de Most Significant Change se identificaron, entre otros hallazgos, las distintas formas como se expresa la VBG en la población adolescente y joven, así como la importancia de la articulación de los talleres para profundizar conocimientos, con el teatro como catalizador de emociones, así como con la producción de televisión como escenario de participación para trabajar en torno a la VBG. Estos hallazgos enriquecen la evidencia previa en torno a cómo la Comunicación para el Cambio Social y de Comportamiento y particular el edu-entretenimiento y la movilización social pueden aportar desde el diálogo, el debate y la reflexión a la prevención y disminución de las VBG en la población adolescente y joven.

ABSTRACT This article examines the process of generating dialogue, debate, and reflection on Gender-Based Violence (GBV) in adolescents in the municipality of San Juan Nepomuceno (Bolívar), within the framework of the realization of an edutainment and social mobilization pilot strategy named "Revealed from all positions," implemented in several municipalities in Colombia. Focus groups, interviews, and the Most Significant Change technique were used in this study to identify the different ways in which GBV is being expressed among the adolescent and young population. Among other findings, the study identified the importance of articulating workshops to deepen knowledge by using theater as a catalyst for emotions and television production as a setting to promote participation to work around GBV. These findings enrich the previous evidence regarding how Communication for Social and Behavioral Change, particularly education, entertainment, and social mobilization, can contribute through dialogue, debate, and reflection to prevent and reduce GBV in adolescents and the young population.

Cognition and epilepsy: Cognitive screening test / Cognição e epilepsia: teste de triagem cognitiva

ABSTRACT. Cognitive deficits often occur in people with epilepsy (PWE). However, in Brazil, PWE might not undergo neurocognitive evaluation due to the low number of validated tests available and lack of multidisciplinary teams in general epilepsy outpatient clinics. Objective: To correlate Brief Cognitive Battery-Edu (BCB-Edu) scores with epilepsy characteristics of 371 PWE. Methods: Clinical and cognitive assessment (MMSE, BCB-Edu) of 371 PWE aged >18 years was performed. The clinical aspects of epilepsy were correlated with BCB-Edu data. Cognitive data of PWE were compared against those of 95 healthy individuals (NC), with p-<0.05. Results: People with epilepsy had lower cognitive performance than individuals in the NC group. Cognitive aspects also differed according to epilepsy characteristics. Predictive factors for impairment in multiple cognitive domains were age and use of more than one antiepileptic drug (logistic regression; R2 Nagelkerke=0.135). Conclusion: Worse cognitive performance was found in PWE on different domains. There was a relationship between cognitive impairment and the aspects of epilepsy. BCB-Edu proved to be effective as a cognitive assessment screening test for epilepsy in adults.

RESUMO. É frequente a ocorrência de déficits cognitivos em pessoas com epilepsia (PWE). Entretanto, no Brasil, as PWE podem ficar sem avaliação neurocognitiva pelo reduzido número de testes disponíveis e validados para nossa cultura e pela ausência de equipes multidisciplinares em ambulatórios gerais de epilepsia. Objetivo: Relacionar os escores do Brief Cognitive Battery-Edu (BCB-Edu) aos aspectos da epilepsia de 371 PWE. Métodos: Foi feita avaliação clínica e cognitiva (MMSE, BCB-Edu) de 371 PWE com idade > 18 anos. Foram relacionados os aspectos da epilepsia com os dados do BCB-Edu. Os dados cognitivos foram comparados aos de 95 indivíduos normais (NC), com p<0.05. Resultados: PWE apresentam desempenho cognitivo inferior ao do grupo NC. Os aspectos cognitivos foram distintos, segundo aspectos da epilepsia. Na regressão logística, os fatores preditivos para comprometimento em múltiplos domínios cognitivos foram a idade e a utilização de mais de uma droga antiepiléptica (R2 Nagelkerke=0.135). Conclusão: Houve, nas PWE, pior desempenho cognitivo em diferentes domínios. Houve relação entre déficit cognitivo com aspectos da epilepsia. O BCB-Edu mostrou-se eficaz como teste de triagem cognitiva na epilepsia em adultos.

Effect of Lifestyle based Edu Vaccine in Indian community: Study Outcomes of National Program for Prevention and Eradication of Heart Attack (NPPEHA)

Objective: The present study was designed to evaluate the impact of Education (Edu) vaccine in National Program forPrevention and Eradication of Heart Attack (NPPEHA).Methods: This pretest–posttest designed study was held in the SAAOL Heart Center in different cities (Delhi,Kolkata, Bangalore, and Mumbai) of India from Nov 2016 to Dec 2017. Total 6,225 community people were enrolled.An educational counseling intervention (Edu vaccine) comprising: knowledge of heart, heart disease awareness,risk factor awareness, preventive measure awareness and diagnostic, and regular medical checkups were given tocommunity people with expert doctors through face-to-face interactions and video counseling. The effect of lifestylebased counseling was assessed through pre- and post-designed Edu vaccine questionnaire.Results: The results of this study showed a significant improvement in knowledge of heart (79.6%), heart diseaseawareness (87.8%), risk factor awareness (74.9%), preventive measure awareness (89.8%), diagnostic, and regularmedical checkups (84.7%), respectively.Conclusion: The results of this study showed a significant improvement in knowledge of heart (79.6%), heart diseaseawareness (87.8%), risk factor awareness (74.9%), preventive measure awareness (89.8%), diagnostic, and regularmedical checkups (84.7%), respectively. The first phase study of NPPEHA results conclude that lifestyle-based Eduvaccine is effective, and this tool is very easy to follow and heart attack prevention methods. The next phase ofNPPEHA program is ongoing and results are awaited.

Cuidado peri-operatorio integral centrado en el paciente: un paso más hacia la ampliación de los horizontes de la anestesiología / Comprehensive patient-centered perioperative care: another step towards expanding horizons in anesthesiology

Abstract We must change the current perioperative care model and expand the horizons of our specialty, as the results are unsatisfactory, health systems are unviable, and an imminent crisis is predicted. Although the contributions made by anesthetists have improved the safety of care and have contributed to increase the life expectancy and the quality of life of the population, it is necessary to adopt a comprehensive, patient-centered care model. This involves adapting to new settings of clinical practice, extending anesthetist intervention times, and rethinking the professional competencies that must be demonstrated by those who will practice in the near future. Therefore, we must identify our training deficiencies and start working immediately on overcoming them. The objective of this article is to reflect on the problems of the current model, the solutions proposed by the new models and the successes, difficulties, and opportunities that have been observed during its implementation.

Resumen Debemos cambiar el modelo de atención perioperatoria actual y ampliar los horizontes de nuestra especialidad, porque los resultados son insatisfactorios, los sistemas sanitarios son inviables y se predice una crisis inminente. A pesar de que los aportes hechos por los anestesiólogos han mejorado la seguridad de la atención y han contribuido a incrementar la calidad y la duración de la vida de la población, se hace necesario adoptar un modelo integral, centrado en el paciente, que implica adaptarse a nuevos escenarios de práctica clínica, ampliar los tiempos de intervención del anestesiólogo y replantear las competencias profesionales que deben demostrar quienes ejercerán en un futuro próximo. Por ello, debemos identificar nuestras deficiencias formativas y empezar de inmediato a superarlas. El objetivo de este artículo es hacer una reflexión sobre los problemas del modelo actual, las soluciones propuestas por los nuevos modelos y los aciertos, dificultades y oportunidades que se han observado durante su implementación.

The effect of adipose-derived stem cells on the lung colonization, TNF-α and IL-4 in rats with LPS-induced acute lung injury / 中华急诊医学杂志

Objective To explore the effect of 5-ethynyl-2'-deoxyuridine (EdU) -labeled adipose-derived stem cells (ADSCs) on lung colonization, TNF-α and IL-4 in rats induced by lipopolysaccharide (LPS) with acute lung injury. Methods Thirty male Sprague-Dawley (SD) rats were randomly divided into the normal control group (n=10), LPS model group (n=10), and LPS+ADSCs intervention group (n=10). The ALI model rats were intraperitoneally injected with 8 mg/kg LPS, rats in the normal control group were intraperitoneally injected with 4 mL/kg physiological saline, and rats in the LPS+ADSCs group were intravenously injected with 300 μL ADSCs by tail vein after 30 minutes for the ALI model establishment, and rats in the normal control group and LPS group were intravenously injected with 300μL physiological saline by tail vein. The time of death in rats was observed, lung tissue and blood from left ventricular were collected, and the serum tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-4) were detected by Enzyme-linked immunosorbent assay (ELISA). Lung wet/dry weight (W/D) ratio was detected by thoracotomy, the pathological changes of lung tissue were observed under optical microscope, and the colonization of ADSCs in the lungs were observed under immunofluorescence microscopy. LSD-t method was used to compare between every two groups. Results There was no significant difference in mortality between the LPS group and LPS + ADSCs group (50％ vs. 70％, P> 0.05); EdU-labeled ADSCs were extensively colonized in the lungs by tail vein injection after 24 h; Compared with the normal control group, the lung injury of the LPS group was heavier, the ratio of lung W/D and TNF-α were significantly increased (all P< 0.01), and IL-4 level was significantly decreased (P< 0.01). Compared with the LPS model group, the degree of lung injury in the LPS + ADSCs group was significantly reduced, lung W/D ratio (5.57±0.27 vs. 5.98±0.28) and TNF-α level of blood [(41.51±4.14)ng/L vs. (45.52±3.74)ng/L] were significantly reduced (all P< 0.05), whereas the IL-4 levels were significantly increased [(7.01±1.11)pg/mL vs. (3.27±0.54)pg/mL, P< 0.05]. Conclusions EdU-labeled ADSCs could be colonized in the lungs of LPS-induced ALI rats, reduce the inflammatory response from TNF-α and improve the anti-inflammatory response from IL-4.

Establishment of a method for the evaluation of emergency granulopoiesis in mouse bone marrow with EdU / 中华微生物学和免疫学杂志

Objective To label granulocytes in a state of differentiation in mouse bone marrow (BM) with EdU (5-ethynyl-2′-deoxyuridine) for further understanding the changes in granulocyte produc-tion at different stages of differentiation during inflammation. Methods C57BL/6 mice were intraperitoneal-ly (i.p.) injected with EdU and heat-inactivated Escherichia coli(HI E.coli). BM cells were harvested at different time points after HI E.coli injection and then stained with fluorescent-conjugated antibodies(Abs). Myeloblasts,promyelocytes,myelocytes, metamyelocytes and band and segmented neutrophils were identi-fied by fluorescence-activated cell sorting(FACS). The percentage of EdU-positive cells in each population was recorded. Results The percentage of EdU-positive myeloblasts in mice increased by 10.0% at 24 h af-ter intraperitoneal injection with HI E.coli,but decreased by 75.0% and 23.0% at 48 h and 72 h,respec-tively. The percentage of EdU-positive promyelocytes declined by 23.0%,54.5%,64.3% and 77.8% at 24 h,48 h,72 h and 96 h,respectively. The percentage of EdU-positive myelocytes increased by 60.0% and 10.0% at 24 h and 48 h,but decreased by 80.0% and 90.0% at 72 h and 96 h. The percentage of EdU-positive metamyelocytes increased by 50.0% at 24 h,but decreased by 33.3%,61.5% and 66.7% at 48 h,72 h and 96 h. The percentage of EdU-positive band and segmented cells increased by 14.0% at 24 h,but decreased by 50.0%, 77.8% and 88.0% at 48 h, 72 h and 96 h. Conclusion Emergency granulopoiesis occurred 24 h after the establishment of HI E.coli-induced model of acute peritonitis, which meant that the proliferation of myeloid precursor cells,especially that of myelocytes and metamyelocytes,was accelerated and resulted in increasing number of mature neutrophils immigrating to sites of inflammation.

Effect of bone mesenchymal stem cell transplantation on accelerating the vascularization surrounding transplant pancreatic islet / 器官移植

Objective To investigate whether pancreatic islet transplantation in combination with bone mesenchymal stem cells (MSC) transplantation can promote the vascularization surrounding the transplant pancreatic islet.Methods The non-obese diabetic (NOD) mice were utilized as the recipients and randomly divided into pancreatic islet transplantation combined with MSC transplantation group (co-transplantation group,n=6),pancreatic islet transplantation group(n=6),MSC transplantation group(n=6) and sham transplantation group (n=3).The variation in blood glucose level and survival rate post-transplantation of NOD mice in each group was observed.The proliferation and apoptosis of the transplant pancreatic islet in the pancreatic islet transplantation group and co-transplantation group at 1,2 and 4 weeks after pancreatic islet transplantation were analyzed by 5-ethynyl-2'-deoxyufidine (EdU) and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL).The vascular density surrounding the transplanted pancreatic islet in the pancreatic islet transplantation group and co-transplantation group at postoperative 2,4 and 8 weeks were observed under light microscope and quantitatively analyzed by histochemical and immunohistochemical staining.Results Both MSC combined with pancreatic islet transplantation and pancreatic islet transplantation significantly improved the blood glucose level and enhanced the survival rate of NOD mouse models after transplantation.In addition,it could accelerate the regeneration of pancreatic islet cells and decrease cell apoptosis.MSC combined with pancreatic islet transplantation significantly enhanced the vascular density surrounding the transplant pancreatic islet compared with pancreatic islet transplantation alone.Conclusions MSC transplantation can accelerate the vascularization surrounding the transplant pancreatic islet,increase the blood supply and protect the function and activity of the transplant pancreatic islet.

A preliminary study on the permeation of scientific aesthetics in medical biochemistry teaching / 中华医学教育探索杂志

Scientific aesthetic is an important part of humanistic quality education. The penetration of scientific aesthetic education in medical biochemistry teaching can enable students to understand the medical knowledge from the aesthetic perspective, which not only can improve the humanistic quality stu-dents, but also can arouse the interest of students in learning and enhance the teaching effect. Aesthetics of science in biochemistry mainly includes the beauty of molecular structure, the beauty of balance, the beauty of coordination and the beauty of simplicity. When we penetrate the scientific aesthetic education in bio-chemistry teaching, we need to think about characteristics of biochemistry and follow the principle of mod-eration, and we need appropriate forms and comply with students' emotional experience.

Protagonista da amamentação ou instrumento da política de saúde infantil?: a enunciação da mulher nos materiais oficiais de promoção e orientação ao aleitamento materno / Protagonist of breastfeeding or an instrument of child health policy?: the enunciation of women in official promotional and guidance materials to breastfeeding

Este artigo analisa materiais de promoção e orientação ao aleitamento materno recentes, produzidos pelo Ministério da Saúde (MS) brasileiro, identificando aproximações e diferenças entre os discursos voltados a gestantes e lactantes e aqueles dirigidos a profissionais de saúde em relação aos sentidos propostos acerca da mulher. Com base na teoria da enunciação, identificamos que, mesmo permanecendo o eu ou sujeito da enunciação dos discursos analisados, identificado como MS, persistem distinções significativas na abordagem da mulher. Nos manuais para profissionais de saúde, nos quais a mulher é o sujeito sobre quem se fala, é mais comum ela aparecer representada como indivíduo dotado de subjetividade e protagonista do processo. Por outro lado, de modo geral, as mulheres são tratadas de forma objetificada nos materiais voltados a elas mesmas, o que se revela por meio de linguagem normativa e imperativa que as configura como instrumento da política oficial de saúde infantil. Defendemos que compreender como o objeto de que se fala é constituído por/nesses discursos, assim como desvelar como neles se constroem as posições de sujeito e relações de poder, possibilita -nos problematizar essa comunicação que, de modo geral, negligencia as experiências e expectativas da mãe no processo de amamentação.

This article examines recent promotion and guid ance materials to breastfeeding produced by the Brazilian Ministry of Health, identifying similari ties and differences between the discourses aimed at pregnant and lactating women, and those directed to health professionals in relation to the proposed meanings about women. Based on the theory of enunciation, we identified that, while the self or subject of enunciation is still present in the ana lyzed discourse (identified as Brazilian Ministry of Health), significant distinctions persist in the ap proach of the women's role. In manuals for health professionals, in which the woman is the subject of whom it talks about, she is commonly represented as an individual with subjectivity who is the protago nist of the process. On the other hand, in materials aimed at women, we observed that, in general, they are treated in an objectified way, revealed through a normative and imperative language, which quali fies them as an instrument of the official policy for child's health. We argue that understanding how the object spoken is created by/in these discourses, unveiling how positions and power relations are constructed in them, enables us to discuss this com munication that generally has neglected the experi ences and expectations of mothers in breastfeeding.

Discussion on the Cultivation of Medical Students′Consciousness of Responsibility / 中国医学伦理学

This article discussed the importance and current dilemmas of the cultivation of medical students′consciousness of responsibility based on the special relationship between professionality and responsibility. The di-lemmas mainly included the followings:the motivation to select the Medicine specialty was impure, the humanistic quality was lacking, and the workplace showed reverse guidance. In addition, it expounded the methods to strengthen the cultivation of medical students′ responsibility consciousness from three aspects, which included the cultivation of social responsibility, the practical training teaching of humanities quality and the clinical teaching practice.

Repetitive magnetic stimulation promotes neural stem cells proliferation by upregulating MiR-106b in vitro / 华中科技大学学报（医学）（英德文版）

Neural stem cells (NSCs) proliferation can be influenced by repetitive transcranial magnetic stimulation (rTMS) in vivo via microRNA-106b-25 cluster, but the underlying mechanisms are poorly understood. This study investigated the involvement of microRNA-106b-25 cluster in the proliferation of NSCs after repetitive magnetic stimulation (rMS) in vitro. NSCs were stimulated by rMS (200/400/600/800/1000 pulses per day, with 10 Hz frequency and 50% maximum machine output) over a 3-day period. NSCs proliferation was detected by using ki-67 and EdU staining. Ki-67, p21, p57, cyclinD1, cyclinE, cyclinA, cdk2, cdk4 proteins and miR-106b, miR-93, miR-25 mRNAs were detected by Western blotting and qRT-PCR, respectively. The results showed that rMS could promote NSCs proliferation in a dose-dependent manner. The proportions of ki-67+ and Edu+ cells in 1000 pulses group were 20.65% and 4.00%, respectively, significantly higher than those in control group (9.25%, 2.05%). The expression levels of miR-106b and miR-93 were significantly upregulated in 600-1000 pulses groups compared with control group (P<0.05 or 0.01 for all). The expression levels of p21 protein were decreased significantly in 800/1000 pulses groups, and those of cyclinD1, cyclinA, cyclinE, cdk2 and cdk4 were obviously increased after rMS as compared with control group (P<0.05 or 0.01 for all). In conclusion, our findings suggested that rMS enhances the NSCs proliferation in vitro in a dose-dependent manner and miR-106b/p21/cdks/cyclins pathway was involved in the process.

Ambulatory blood pressure monitoring effect with health education in children with orthostatic hyper-tension / 中国小儿急救医学

Objective To analyse the 24 h ambulatory blood pressure monitoring(ABPM)character-istics and effect of health education in children with orthostatic hypertension (OHT)retrospectively.Methods A total of 19 children[1 1 males and 8 females with mean age of (1 1.26 ±2.16)years]who were outpa-tients or had been hospitalized in the Second Xiangya Hospital of Central South University due to unexplained syncope,presyncope,and finally diagnosed as OHT after head up tilt test(HUTT).HUTT and ABPM were reexamined at 12 ~190(47 ±48 )days after receiving health education (including psychological guidance, avoiding sudden changes in posture,increasing the amount of water,avoiding syncope inducement,etc). Results (1 )ABPM parameters:there were no significant differences of ABPM parameters before and after health education respectively(P ﹥0.05,respectively).(2)After the health education,HUTT 3 min diastolic pressure[(71.89 ±1.60)mmHg vs.(76.47 ±8.49)mmHg,1 mmHg =0.133 kPa,t =2.785,P ﹤0.05]and diastolic blood pressure change[(7.37 ±4.98)mmHg vs.(12.42 ±3.27)mmHg,t =3.560,P ﹤0.05]de-creased than those before health education.(3 )Blood pressure pattern changes:after the health education,“dipper blood pressure”increased and “non-dipper blood pressure”decreased[42.1 %(8 /19)vs.31.6%(6 /19)and 57.9%(1 1 /19)vs.68.4%(13 /19),χ2 =0.452,P ﹥0.05,respectively].(4)OHT cure rate:after health education,to review the HUTT,within 3 minutes in HUTT,blood pressure changes of 14 cases were normal range.The cure rate was 73.7%.Conclusion OHT children's blood type is given priority to with “non-dipper blood pressure”,and the ratio of“dipper blood pressure”increase and the HUTT 3 min di-astolic pressure and diastolic blood pressure change decrease after health education.It suggests that the health education of OHT children has a certain clinical effect.

Application of surgery experience teaching in early clinical contact education / 中华医学教育探索杂志

To discover medical teaching method which is more funny and effective in early clinical contact education, Eye optical hospital affiliated to Wenzhou Medical University set up oph-thalmic microsurgery experience teaching course for junior medical students and set a variety of eye surgery simulation experience content, such as conjunctival suture surgery, corneal suture surgery, cataract surgery, eye surgery simulation and so on, which can effectively arouse students' professional interest in learning and promote students' thinking and exploration to their profession.

Establishment of multi-dimension teaching model for basis of clinical laboratory course / 中华医学教育探索杂志

According to the constructivism approach, instructors have to adapt to the role of fa-cilitators but not teachers. Whereas a teacher gives a didactic lecture that covers the subject matter , a fa-cilitator helps the learner to get to his or her own understanding of the content. In the former scenario the learner plays a passive role and in the latter scenario the learner plays an active role in the learning pro-cess. Under the guidance of this theory, a multi-dimension teaching model based on classroom teaching, network platform and innovate experiments has been established in the course of basis of clinical labora-tory. It has been found that this model is conducive to raising students' interests in learning and to culti-vating student's comprehensive quality.

Screening for cognitive impairmentin late onset depression in a Brazilian sample using the BBRC-EDU / Rastreio de comprometimento cognitivo na depressão de início tardio em uma amostra brasileira usando o BBRC-EDU

ABSTRACT: Depression and dementia are the most prevalent neuropsychiatric disorders in the elderly population. Alzheimer's disease is the leading cause of dementia in most countries, being responsible for more than half of all dementia cases. Late-onset depression is a frequent cause of cognitive decline in the elderly. Differentiating between cognitive impairment secondary to depression and incipient dementia poses a challenge in the clinical setting. Objective: To evaluate the performance of elderly depressed patients using the BBRC-Edu. Methods: We studied 25 patients with late onset depression (mean age: 73.6 y (6.6); schooling: 9.1 y (5.7)) and 30 patients with mild AD (mean age 76.6 y (5.4); schooling: 7.5 y (7.1)), who were compared to a control group of 30 healthy elderly (mean age 73.8 y (5.8); schooling: 9.1 y (5.4)) using the CERAD and BBRC-Edu batteries. Results: For the CERAD battery, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Constructional Praxis (p>0.05), and performed poorer than controls on verbal fluency (animals) and Word List Recall tasks (p<0.0001). For the BBRC-Edu, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Digit Span (direct order) (p=0.076) and Incidental Memory (p>0.05), and performed worse than controls on Learning (second presentation) and verbal fluency (fruits) tasks (p<0.0001). Conclusion: Overall performance on the BBRC-Edu allowed differentiation of controls and depressed patients from AD patients.

RESUMO: Depressão e demência são os transtornos neuropsiquiátricos de maior prevalência na população idosa. A doença de Alzheimer é a principal causa de demência na maioria os países, sendo a responsável por mais da metade dos casos de demência. Depressão de início tardio é uma causa frequente de declínio cognitivo no idoso. A diferenciação entre transtorno cognitivo secundário à depressão e demência em fase inicial é um desafio na prática clínica. Objetivo: Avaliar o desempenho de pacientes idosos deprimidos usando a Bateria Breve de Rastreio Cognitivo (BBRC-Edu). Métodos: Estudamos 25 pacientes com depressão de início tardio, (idade média 73,6 (6,6); escolaridade: 9,1 (5,7)) e 30 pacientes com DA leve (CDR=1), (idade média 76,6 (5,4); escolaridade: 7,5 (7,1)). O desempenho de ambos os grupos foi comparado a um grupo controle de 30 idosos sadios (idade média 73,8 (5,8); escolaridade: 9,1 (5,4)). Resultados: Na Bateria CERAD pacientes deprimidos tiveram desempenho melhor que pacientes com DA em todos os testes (p<0,0001) exceto para Praxia Construcional (p>0,05), e desempenho pior que os controles na fluência verbal (animais) e Recordação da Lista de Palavras (p<0,0001). Na BBRC-Edu, pacientes deprimidos tiveram melhor desempenho comparados aos pacientes com DA em todos os testes (p<0,0001) exceto para Spam de Dígitos (ordem direta) (p=0,076) e Memória Incidental (p>0,05), e tiveram desempenho pior que os controles na Aprendizagem (segunda apresentação) e na fluência verbal (frutas) (p<0,0001). Conclusão: A Bateria Breve de Rastreio Cognitivo permite a diferenciação de controles e pacientes com transtorno depressivo, de pacientes com doença de Alzheimer.

On Arguments about General Education among Chinese Researchers / 中华医学教育探索杂志

During the reform of higher education, Chinese researchers began to do more and more research on generaleducation. But there are still some arguments that need clarifying on the issues of general education among Chineseresearchers, In this article, the author analyzes and points out the different opinions on general education in Chinathrough the following aspects: the different translation of general education from English into Chinese; the definition ofgeneral education; the relationship between general education and humanities education, specialized education, andquality-oriented education; the way of general education practice; and the time limitation of general education in under-graduate education.[