Practice and exploration of post competency-based assessment evaluation system for medical students / 中华医学教育探索杂志

Post competency-based medical education complies to the development and philosophy of modern medicine. This paper completely illustrates how to construct a scientific and diversified assessment evaluation system guided by post competency for medical students which combines formative assessment and summative assessment. Through the objective measurement and timely feedback of various abilities of medical students, the closed-loop feedback system of assessment and evaluation can be constructed to guide the exploration and practice of teaching process in reverse.

Effect of Bi-level positive airway pressure ventilation combined with Seretide on quality of life of elder patients with moderate and severe chronic obstructive pulmonary disease and type Ⅱ respiratory failure / 中国综合临床

Objective To investigate the effect of Bi-level positive airway pressure ventilation (BiPAP) combined with Seretide on quality of life of elder patients with moderate and severe chronic obstructive pulmonary disease (COPD) and type Ⅱ respiratory failure.Methods Eighty elderly patients with moderate to severe COPD and type Ⅱ respiratory failure were selected and randomly divided into observation group (n =40) and control group(n =40).The two groups were given conventional anti infection,oxygen inhalation,spasmolysis,expectorantand other conventional treatment,and the use of BiPAP ventilator assisted ventilation.Patients in observation group were administered the combined of Seretide and BiPAP treatment,and patients in control were received only BiPAP.Arterial blood gases before and after 7 d treatment,lung function and quality of life evaluation results (SQGR score) before and after 7 d,3 months and 6 months treatment,were measured.Results There were significant differences in terms of arterial blood gases,pulmonary function key indicators,SQGR score between two groups before and after treatment(P ＜ 0.01).PaCO2 was significantly after 7 d of treatment in observed group was (42.9 ± 7.9) mmHg,lower than that of the control group ((47.6 ± 8.0) mmHg; t =8.467,P ＜0.001).There was no significant difference in terms of forced expiratory volume in one second(FEV1) in both groups at 7 d,3 months,6 months after treatment (P ＞ 0.05).FEV1/forced vital capacity (FVC) in two group at 3 months,6 months after treatment were different compared to 7 d after treatment (observation group:(49.9 ±5.1)％ and (47.1 ±4.2)％,(50.2 ± 5.0)％ and(47.1 ±4.2)％ ;control group:(49.0 ± 5.4)％and (46.6 ± 5.9) ％,(49.8 ± 5.2) ％ and (46.6 ± 5.9) ％ ; P ＜ 0.05).SQGR score in observation group at six months after treatment were (40.8 ± 8.5),significantly lower than that of 7 d after treatment(45.9 ± 10.8),P ＜ 0.05),and significantly lower than the control group after 6 months of treatment ((40.8 ± 8.5) vs (46.0± ± 8.0),P ＜ 0.05).Conclusion Seretide combined with BiPAP treatment can significant improve lung function and the quality of life of patients with moderate and severe COPD and type Ⅱ respiratory failure.

Clinical study on intestinal fatty acid binding protein and the endotoxin in early diagnosis of intestinal barrier dysfunction / 中华消化杂志

Objective To screen the high specific and sensitive monitoring indications in the diagnosis of intestinal barrier dysfunction.Methods A total of 70 critical patients with intestinal barrier dysfunction and acute physiology and chronic health evaluation (APACHE) Ⅱ score≥8 and over the same period 41 patients without intestinal barrier dysfunction and APACHE Ⅱ score≤6 were recruited.The general information,histories,symptoms,physical signs,24 hours urine output and the condition of mechanical ventilation treatment were recorded.The venous blood was taken for bacteria culture,white blood cell counting,creatinine level,diamine oxidase (DAO) activity,D-lactic acid,intestinal fatty acid binding protein (IFABP) and endotoxin level testing.The urine was taken for urinary IFABP level testing.Twenty-four hours urine was reserved for 24 hours total urinary IFABP testing.The factors which might influence intestinal barrier dysfunction were analyzed by univariate analysis and multivariate analysis.The measurement data were analyzed by t test and the count data were analyzed by x2 test.The factors were screened according to receiver operating characteristic (ROC) curve.Results The factors related with intestinal barrier dysfunction were white blood cell counting (OR=3.971,P=0.046),plasma endotoxin level (OR=7.857,P=0.005)and 24 hours total urinary IFABP (OR=11.154,P=0.001).The areas under the ROC curve (AUC)of plasma endotoxin level and 24 hours total urinary IFABP were 0.852 and 0.820 respectively (both P＜0.01).The critical value was 8.0 pg/ml and 17.12 ng respectively.The sensitivity was 97.8％ and 84.4％.The specificity was 66.7％ and 72.7％.Conclusion Once critical patients presented certain gastrointestinal symptoms and physical signs with plasma endotoxin level ＞8.0 pg/ml and or 24 hours total urinary IFABP ＞17.12 ng,which might indicate intestinal barrier dysfunction.

Practice of enhancing clinical thinking training and assessment in medical students / 中华医学教育探索杂志

Objective To strengthen the ability of clinical thinking and the ability to solve practical clinical problems for medical students.Methods Medical undergraduates studying in affiliated hospitals of Tongji university from 2005 to 2010 were enrolled The clinical thinking training and assessment in clinical teaching were enhanced by introducing problem-based learning,case-based learning and by strengthening the role of interns in clinical work and emphasizing clinical thinking ability assessment during various kinds of clinical skills examinations.Meanwhile,the teaching management and supervision were improved.The awareness and ability of clinical teachers to train students′ clinical thinking were aroused and cultivated through teaching staff training so as to ensure that clinical thinking training and assessment were involved in the whole process of clinical teaching.Results The students' abilities of self-study,scientific thinking and oral expression were improved.The passing rates of our graduates in national general medical practitioner test were increasing yearly from 2006 to 2008.Conclusion Strengthening clinical thinking ability training during clinical teaching plays an active role in improving clinical skills in medical students.

Phosphodiesterase 3 inhibitor attenuates cough response in a sensitized guinea pig model / 中国病理生理杂志

AIM: To investigate the effects of selective phosphodiesterase 3 inhibitor olprinone on cough response in guinea pigs sensitized and challenged with ovalbumin. METHODS: Forty sensitized guinea pigs were randomly divided into control ( n = 10), challenged ( n = 10), olprinone ( n = 10) and aminophylline group ( n = 10 ). Two hours after challenged with the aerosol of 1% ovalbumin or saline, animals were intraperitoneally injected either with saline,25 mg/kg of olprinone or 25 mg/kg aminophylline. At 24 h, the injection was repeated with 2. 5 mg/kg and 25 mg/kg olprinone or 2. 5 mg/kg and 25 mg/kg aminophylline respectively in olprinone and aminophylline group, cough response to inhaled capsaicin and airway responsiveness to methacholine (PC150) were measured. Then, total cell number and differential counts were analyzed in bronchoalveolar lavage fluid. RESULTS: The cough frequency was (5 ± 2) times/3 min in control group and (24 ± 3 ) times/3 min in challenged group ( P ＜ 0. 05 ), while PC150 was (659 + 57 ) mg/L in control group and (238 + 67 ) mg/L inchallenged group ( P ＜ 0. 05 ). 25 mg/kg olprinone significantly inhibited the augmented cough response and airway hyperresponsiveness, the cough frequency and PC150 were (15 ±2) times/3 min and (580 ±45) mg/L (P ＜ 0. 05 ), which differed significantly from (18 ± 2) times/3 min and (438± 52) mg/L in aminophilline group (P ＜ 0. 05). However, olprinone failed to reverse the elevated total cell number and percentage of eosinophils in bronchoalveolar lavage fluid from guinea pigs challenged with ovalbumin (P ＞ 0. 05 ). CONCLUSION: Phosphodiesterase 3 inhibitor attenuates cough response associated with eosinophilic airway inflammation by bronchodilatory effect.

Protective effects of emodin(大黄素) on intestinal ischemia/reperfusion injury in rats / 中国中西医结合急救杂志

ObjectiveTo investigate the protective mechanism of emodin(大黄素) on intestinal mucosal injury induced by intestinal ischemia/reperfusion(I/R) in rats.Methods Thirty male Wistar rats were randomly divided into three groups,namely sham operation group(Group A),group of ischemia 45 minutes followed by reperfusion 6 hours(Group B),emodinpretreated group(Group C).The superior mesenteric artery was occluded and then released to produce the intestinal I/R model in rats.Group C was administrated emodin intravenously(2.5 mg/kg) before 30 minutes of the operation.In the sham operation group and model group,similar volume of normal saline was administered respectively.After 45 minutes of ischemia and 6 hours of reperfusion, the blood was collected from the inferior vena cava respectively in each group.Afterwards,the rats were sacrificed,and the mesenteric lymph node(MLN) and small intestinal tissues were taken for pathological analysis by light microscopy.The serum levels of intestinal fatty acid binding protein(IFABP),nitrogen monoxidum(NO),tumor necrosis factor-?(TNF-?),and the activities of malondialdehyde(MDA),superoxide dismutase(SOD),myeloperoxidase(MPO)in the small intestinal tissues were measured,and the rates of bacterial translocation(BT) in blood and MLN were examined at 6 hours after reperfusion in each group. Results The contents of IFABP,NO,TNF-?,MDA and MPO were significantly lower(all P

Effect of stem cell factor antisense oligonucleotide on the interaction of fibroblasts and murine mast cells / 基础医学与临床

Objective To explore the role of stem cell factor(SCF)-mediating fibroblasts and mast cells interaction in pathophysiology process of asthma.Methods We transfected NIH3T3 cells with SCF antisense oligonucleotide(SCF ASON) and detected SCF expression by immunochemistry and RT-PCR.Then,we isolated mast cells from mouse bone marrow and established NIH3T3 and mast cells cocultures.After SCF ASON intervention,histamine and eotaxin levels in culture supernatants were determined by ELISA and fluorometry.Growth curves of fibroblasts and mast cells were drawn.We also observed mast cells apoptosis by AO stain and flow cytometric analysis.Results SCF ASON strikingly down-regulated SCF protein and mRNA level of NIH3T3 cells.SCF ASON intervention inhibited the growth of NIH3T3,and induced mast cell apoptosis in cocultures(14.0%?0.81% at 96 hour).Both histamine[(3.08?0.38)?g/L vs(3.83?0.41)?g/L,P

To Develop the Medical Simulation Education and to Build a Harmonious Environment of Clinical Education / 中华医学教育探索杂志

With the changes in medical model and the enhancement of ethical standard as well as the patients' awareness of right protection,clinical teaching resource shortages have been increasingly prominent.This article analyzes the characteristics and status of clinical medical education and points out that the development of medical simulation education has great significance for building a harmonious clinical training environment centering on the content classification,functional positioning and outstanding advantage of medical simulation education.

Simultaneous determination of ephedrine and pseudoephedrine in Zhisou Lixiao Oral Liquid by HPLC / 中成药

AIM:To set up a method of simultaneously determining the contents of ephedrine and pseudoephedrine in Zhisou Lixiao Oral Liquid (Herba Ephedrae, Radix et Rhizoma Glycyrrhizae, Semen Raphani, etc). METHOD: The HPLC-quantitative analysis was carried out on a column of Sinochrom ODS-BP by using a mobile phase of acetonitrile-0.02 mol/L potassium dihydrogen phosphate (pH=2.7), (4∶100, with 0.1% triethylamine) under a flow rate of 1.5 mL/min. 207 nm was selected as the wavelength of detector. RESULTS: The linear range of ephedrine was 20.8-208.0 ?g/mL(r=0.999 7) and pseudoephedrine's was 15.0-150.0 ?g/mL(r=0.999 8). The recoveries of them were all between 95% and 105%(RSD

THYROID AND PARATHYROID GLANDS OF RHINOPITHECUS / 解剖学报

This paper presents the results of the gross dissection and the histologic observation on the thyroid and parathyroid glands of Rhinopithecus. Specimens used in the studies are composed of R. roxellanae (1 (?), subad.), R. bieti (2 ♀♀, ad.; 1 ♀,juv.) and R. brelichi(2(?)(?),ad.). Besides the position and shape of the gross anatomy of the thyroid and parathyroid glands, attention was paid to the cellular types of the parathyroid glands. Material used for the histologic investigation is stained with HE and the modified Mallory-Azan methods and observed under the light microscopy. The principal results are summarized as follows:1. The thyroid gland consists of two lateral obes. The dimension of the gland measured 18.0?9.0, 15.0?8.0 and 14.0?6.0 mm. in bieti;23.0?9.0 mm. in roxellanae; 25.0?9.0 and 30.0?1.0 mm in brelichi; and one isthmus measures 3.0?10.0, 2.0?10.0 and 2.0?6.0 mm. in bieti; 4.0?6.0 mm. in roxellanae; 5.0?12.0 and 5.0?14.0 mm. in brelichi.The total weight of the gland is 1.0, 0.5 and 0.3g in bieti; 0.9g in roxellanae; 0.9 and 1.8g in brelichi.The isthmus connects the lower edges of two lateral lobes. There is no pyramidal lobe.2. The blood supply is derived from the superior thyroid arteries. There are no inferior thyroid arteries in three kinds. The thyroid venous drainage is by the superior and inferior thyroid veins, there is no median thyroid vein.3. The sizes and shapes of the thyroid vary with species. Each animal possesses two parathyroid glands, one of each side, but their position is also variable in the different animals.4. The follicular epithelium of the thyroid contains two cellular types, viz. the typical follicular epithelial cells and C cells.5. The parathyroid gland of Rhinopithecus is histologically similar to that of Macaca mulatta and man, which contains four basic cellular elements. There is an intermediary cellular type probably a variant of the oxyphil cells.6. Grey blue granules are present in the pale oxyphil cells of the parathyroid glands of both brelichi and bieti.7. There are less oxyphil cells among the parenchymal cells of the parathyroid gland in the subadult roxellanae than in both bieti and brelichi.